Time Lag of Acromegaly Diagnosis and Associated Comorbidities in Sulaymaniyah City/Iraq

Abstract

Background: Acromegaly is a rare endocrine disease. The insidious onset and symptom overlap with frequently found diseases, resulting in an often delayed diagnosis. Objective: To evaluate diagnostic delay in patients with acromegaly and its association with patient findings in Sulaymaniyah, Iraq. Methods: A retrospective cross-sectional study was conducted in 49 patients diagnosed with acromegaly. Patient data were collected through interviews and medical record review. The diagnostic delay was determined as the period between the onset of symptoms and the formal diagnosis. Results: The average diagnostic delay was 3.3 years, and the majority of patients were diagnosed with five years of symptom onset. Hypertension was observed in 32.7% of patients, and unemployment, lower education, cumulative comorbidity burden, and abnormal colonoscopy findings were significantly associated with longer delays. In patients <40 years old, the delay can be more extreme, wherein close to half had not undergone a colonoscopy. Normal finding (34.6%), polyps (15.4%), and malignancy (3.8%). However, in patients aged ≥40 years (46.9%), all underwent colonoscopy; 65.2% were normal, 26.1% had polyps, and 8.7% had malignancy. Overall, colorectal cancer was detected in three patients (6.1%), and there was a statistically significant correlation between age group and colonoscopic findings. Conclusions: Acromegaly diagnostic delay is substantial in the Kurdistan Region and is related to socioeconomic factors, asymptomatic onset, and comorbidity. Increased awareness, access to endocrinology, and broader colorectal screening are essential to improve outcomes.