Prevalence of pituitary adenomas: a community‐based, cross‐sectional study in Banbury (Oxfordshire, UK)

Abstract

SummaryBackground Pituitary adenomas (PAs) are associated with increased morbidity and mortality. The optimal delivery of services and the provision of care for patients with PAs require distribution of the resources proportionate to the impact of these conditions on the community. Currently, the resource allocation for PAs in the health care system is lacking a reliable and an up-to-date epidemiological background that would reflect the recent advances in the diagnostic technologies, leading to the earlier recognition of these tumours. Objectives To determine the prevalence, the diagnostic delay and the characteristics of patients with PA in a well-defined geographical area of the UK (Banbury, Oxfordshire). Patients and methods Sixteen general practitioner (GP) surgeries covering the area of Banbury and a total population of 89 334 inhabitants were asked to participate in the study (data confirmed on 31 July 2006). Fourteen surgeries with a total of 81,449 inhabitants (91% of the study population) agreed to take part. All cases of PAs were found following an exhaustive computer database search of agreed terms by the staff of each Practice and data on age, gender, presenting manifestations and their duration, imaging features at diagnosis, history of multiple endocrine neoplasia type 1 and family history of PA were collected. Results A total of 63 patients with PA were identified amongst the study population of 81,149, with a prevalence of 77AE6 PA cases/ 100,000 inhabitants (prolactinomas; PRLoma: 44AE4, nonfunctioning PAs: 22AE2, acromegaly; ACRO: 8AE6, corticotroph adenoma: 1AE2 and unknown functional status; UFS: 1AE2/100,000 inhabitants). The distribution of each PA subtype was for PRLoma 57%, nonfunctioning PAs 28%, ACRO 11%, corticotroph adenoma 2% and UFS 2%. The median age at diagnosis and the duration of symptoms until diagnosis (in years) were for PRLoma 32AE0 and 1AE5, nonfunctioning PAs 51AE5 and 0AE8, ACRO 47 and 4AE5 and corticotroph adenoma 57 and 7, respectively. PRLoma was the most frequent PA diagnosed up to the age of 60 years (0-20 years: 75% and 20-60 years: 61% of PAs) and nonfunctioning PA after the age of 60 years (60% of PAs). Nonfunctioning PAs dominated in men (57% of all men with PA) and PRLoma in women (76% of all women with PA). Five patients (7AE9%) presented with classical pituitary apoplexy, with a prevalence of 6AE2 cases/100,000 inhabitants. Conclusions Based on a well-defined population in Banbury (Oxfordshire, UK), we have shown that PAs have a fourfold increased prevalence than previously thought; our data confirm that PAs have a higher burden on the Health Care System and optimal resource distribution for both clinical care and research activities aiming to improve the outcome of these patients are needed.

ACTH and gonadotropin deficiencies predict mortality in patients treated for nonfunctioning pituitary adenoma: long‐term follow‐up of 519 patients in two large European centres

“…They constitute one‐third of all pituitary neoplasms2, 3 and have a prevalence of approximately 22 cases per 100 000 population 4. Postoperative radiotherapy (RT) is effective at reducing the risk of tumour regrowth after transsphenoidal surgery (TSS) 5, 6.…”

T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly

“…Acromegaly is usually caused by a GH-secreting pituitary adenoma and has a prevalence of 8-12/100,000 people (Daly et al 2006, Fernandez et al 2010. Neurosurgical resection is the gold standard in acromegaly management (Katznelson et al 2014), but remission after surgery alone is infrequent in macroadenomas, which constitute the majority of these tumors (Starke et al 2013, Sarkar et al 2014, Cuevas-Ramos et al 2015.…”

Downregulation of miR-410 targeting the cyclin B1 gene plays a role in pituitary gonadotroph tumors

“…1,2 Virtually all organs or tissues are affected directly or indirectly by the hormones secreted by the anterior pituitary. 3,4 Pituitary adenomas result of a multistep process in which the multi-causal and inherited genetic predisposition, endocrine factors, and specific somatic mutations are factors that may contribute to their development.…”

“…5,6 Gonadotroph adenomas constitute the vast majority of clinically nonfunctioning pituitary adenomas, which account for 15-22% of all pituitary adenomas overall 1,2 and up to 57% of those developing in male patients. 2 They are diagnosed primarily in middleaged patients because of tumor mass effects. Due to the lack of specific pharmacological therapy, surgery remains the first line treatment in affected patients.…”