A positive effect of GH treatment on CVD and fracture risk could be concluded , but study design limitations have to be considered .
Stroke and secondary brain tumours remained more prevalent .
Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment .
All fatal and nonfatal malignancies were not more prevalent in  GH-treated adults compared to the general population .
Due to the positive effects demonstrated in r and omized clinical trials on cardiovascular surrogate markers and bone metabolism , a positive effect of growth hormone ( GH ) treatment on clinical ly relevant end-points seems feasible .
In this review , we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency ( GHD ) with emphasis on morbidity : fatal and nonfatal cardiovascular disease ( CVD ) and stroke , fractures , fatal and nonfatal malignancies and recurrences , and diabetes mellitus .
Incidence of second neoplasm in childhood cancer survivors treated with GH: an analysis of GeNeSIS and HypoCCS.
OBJECTIVE Childhood cancer survivors are commonly treated with GH for GH deficiency that develops either as a result of primary malignancy or its treatment . One study --the Childhood Cancer Survivor Study (CCSS)--demonstrated increased risk of second neoplasm ( SN ) in GH-treated childhood cancer survivors compared with non-GH treated , after adjusting for key risk factors . We assessed the incidence of SN in GH-treated childhood cancer survivors in outpatient observational studies of GH replacement . DESIGN Retrospective analysis of two prospect i ve cohort studies that collected data on safety of GH replacement as prescribed in clinical practice . METHODS Childhood cancer survivors enrolled in Eli Lilly and Company 's pediatric ( Genetics and Neuroendocrinology of Short Stature International Study ( GeNeSIS ) ) and adult ( Hypopituitary Control and Complications Study ( HypoCCS ) ) observational studies of GH treatment were assessed for incidence of SN . RESULTS The percentage of childhood cancer survivors treated with  GH  who developed a SN was 3.8 % in pediatric GeNeSIS participants and 6.0 % in adult HypoCCS participants . The estimated cumulative incidence of SN at 5 years of follow-up in these studies was 6.2 and 4.8 % respectively . CONCLUSIONS The incidence of SN in GeNeSIS and HypoCCS GH-treated participants is similar to the published literature and is thus consistent with increased risk of SN in childhood cancer survivors treated with GH . As follow-up times were relatively short ( <3 years ) , longer observation is recommended . Nevertheless , clinicians should be alerted to the possibility of increased risk of SN in childhood cancer survivors treated with GH  and continue chronic surveillance
A positive effect of GH treatment on CVD and fracture risk could be concluded , but study design limitations have to be considered .
Stroke and secondary brain tumours remained more prevalent .
Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment .
All fatal and nonfatal malignancies were not more prevalent in  GH-treated adults compared to the general population .
Due to the positive effects demonstrated in r and omized clinical trials on cardiovascular surrogate markers and bone metabolism , a positive effect of growth hormone ( GH ) treatment on clinical ly relevant end-points seems feasible .
In this review , we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency ( GHD ) with emphasis on morbidity : fatal and nonfatal cardiovascular disease ( CVD ) and stroke , fractures , fatal and nonfatal malignancies and recurrences , and diabetes mellitus .