Background: The increased morbidity and mortality of acromegaly makes early diagnosis and therapy critical. However, whether the type of medical professional who first diagnoses acromegaly, the major complaint prompting medical attention, or the management paradigms utilized in the setting of novel medical therapies, have changed over time has not been well explored.

Objective: To identify the medical professional who first suspected acromegaly and the complaint prompting the diagnosis and if these have changed. Additional goals were to assess the interval from symptom onset to diagnosis of acromegaly and to compare treatment trends over consecutive decades.

Design: Case-record retrospective study.

Setting: Neuroendocrine Clinical Center at a tertiary care center.

Subjects: 100 patients (45 men and 55 women) with acromegaly referred from 1985–2005.

Results: Acral changes (24%) and headaches (20%) were most prevalent presenting symptoms prompting diagnosis. Eighteen % reported no symptoms of acromegaly at diagnosis. The primary care physician most often initiated the evaluation (44%). Co-morbidities were more prevalent in older patients (p = 0.001). The interval between symptom onset and diagnosis decreased, compared to previous reports. Radiation therapy was used less frequently in the decade after 1994 than in the prior (8 vs. 24%; p = 0.005).

Conclusions: The primary care doctor plays the major role in diagnosis of acromegaly. Increased use of brain MRI may contribute to the many incidentally discovered cases and to the shortened time interval to diagnosis. Presumably due to availability of new medical therapies, use of radiation therapy has decreased.