ECE2018 Poster Presentations: Adrenal and Neuroendocrine Tumours Pituitary - Basic (3 abstracts)
Gender differences in delays to diagnosis of acromegaly: data from the Swedish National Patient Register
Daniel Granfeldt 1 , Æse Björstad 1 , Marlow Tom 1 , Anthony Berthon 2 , Jérôme Dinet 2 , Peter Myrenfors 3 , Eva Lesén 1 , Ingela Björholt 1 , Daniel S. Olsson 4, & Gudmundur Johannsson 4,
1Nordic Health Economics, Gothenburg, Sweden; 2Ipsen, Boulogne-Billancourt, France; 3Ipsen, Stockholm, Sweden; 4Department of Internal medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 5Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acromegaly is a complex disease with an insidious onset and diagnosis can be delayed. The aim of the study was to investigate the diagnostic delay (DD), for patients with acromegaly due to a pituitary tumour in Sweden. Data were obtained from the Swedish National Patient Register. Patients diagnosed between January 1, 2011 and December 31, 2013 in Sweden were included (n=135, 69 men, 66 women). For these patients, the occurrence of pre-defined relevant comorbidities was assessed from 1987 and onwards. DD was defined as the time between the first diagnosis (outpatient or inpatient visit) of a relevant comorbidity and the date of acromegaly diagnosis. The median (95% CI of the median) overall DD for all patients included in the analysis was 52.4 (33.4–74.3) months. The median (95% CI of the median) DD for patients diagnosed during 2011 was 57.6 (27.4–80.5) months while corresponding numbers for 2012 and 2013 was 49.3 (13.6–74.3) and 47.7 (4.2–86.8) months, respectively. During the entire study period, there were 39 patients (29%) diagnosed within 6 months while 21 patients (16%) had a DD of more than 120 months. Patients with a first symptom diagnosis categorized as hypertension had a median (95% CI of the median) DD of 17.8 (2.6–120.9) months while corresponding numbers for patients with a first symptom diagnosis categorized as a cardiac diagnosis were 108.8 (1.6–150.8) months. The median (95% CI of the median) DD for men was 21.7 (4.2–53.3) months while it was 76.7 (55.0–89.2) months for women (P=0.0182 using Log rank test). Hazard ratio (95% CI) with women as reference category was 1.50 (1.06–2.11). This analysis focused on a small population, but the reported DD was in line with previous published data. A limitation of this analysis is that data on primary care visits are not included in the registry; therefore, time between first primary care visit and diagnosis of a relevant comorbidity in secondary care is not captured in the DD calculated. During the short time frame of this study no changes in the DD for patients diagnosed during the different years can be detected. There are patients with very long DD, approaching the total follow-up time. This underlines previous findings that acromegaly has an insidious onset and that diagnosis can be complex. In this study, men were diagnosed 3.5 fold faster than women, indicating that women are not correctly diagnosed to the same extent as men.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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