IGF1 and neoplasm: Although the overall mortality rate, as well as cancer-related mortality, in controlled acromegaly are similar to that of the general population, those individuals with active disease and persistently high levels of GH and IGF-I will have higher all-cause mortality rates (between 1.5- and 2.0-fold), including those related to neoplasms, particularly CRC (15, 51, 56).