Endocrine Abstracts

Background: Pituitary adenomas (PA) have traditionally been considered as very rare conditions, with an estimated prevalence of 25 cases/100 000 inhabitants. However, these data have been extracted either from cancer registries or from hospital databases and therefore, may not be accurate.

Aim: To ascertain the prevalence of PA and the characteristics of the patients diagnosed with them in a large population of inhabitants.

Methods: A survey on the GP surgeries of Banbury (Oxfordshire, UK) covering 89 334 inhabitants was carried out following approval from the Local Research Ethics Committee. Finally, 14 out of 16 approached GP Surgeries agreed to participate allowing the inclusion of 81 149 inhabitants. Patients were initially identified through IT search at the Surgeries using relevant search terms. The notes of the selected subjects were scrutinized to confirm the diagnosis.

Results: We found 64 cases (43 females; median age at diagnosis 37 years (range 16–74)) giving a prevalence of 78.87 cases/100 000 inhabitants. The series included 36 prolactinomas (56%), 7 patients with acromegaly (11%), 11 non-functioning adenomas (17%), 1 Cushing’s disease (1.6%) and 9 pituitary masses of unknown functional status (14%). The median symptomatic period before diagnosis (MSP) was recorded in non-apoplectic PA. The global MSP was 1.7 years (48 patients, range 0.5–15 years), and it was longer for acromegaly (4.5 years) and Cushing’s disease (7 years) than for prolactinomas (1.5 years) and non-functioning adenomas (1 year).

Conclusions: This is the first cross-sectional, community study on the epidemiology of PA performed in a large population area of the United Kingdom. The prevalence of PA is three times higher than previously thought, and patients described prolonged symptomatic periods before diagnosis. Resource allocation in health care systems should be based on these updated epidemiological profiles, and increased awareness of these treatable conditions is essential to shorten any diagnostic delay and its potential consequences.