The incidence and prevalence of acromegaly, a nationwide study from 1955 through 2013

Abstract

The incidence of acromegaly in Iceland during the study period was much higher than earlier reports have indicated. During the last 9 years of the study 7.7 patients were diagnosed per million per year. At diagnosis, 38 % had developed hypertension and 10 % were diagnosed during follow up. This indicates the importance of endocrine disorders in the aetiology of hypertension.

Epidemiology of acromegaly: review of population studies

“…Agustsson et al [6] performed a nationwide population study in Iceland and information was obtained from medical records at the National University Hospital, three district hospitals, all privately practicing endocrinologists and gynaecologists in the country, all radiology departments in Iceland, the Icelandic Cancer Registry, the department of pathology and the Icelandic Heart Association. Hoskuldsdottir et al [7] collected data from the medical records at the National University Hospital in Iceland, the largest hospital out of the capital, the largest private outpatient clinic in Iceland and from all endocrinologists treating adult patients in the country. Raappana et al [8] obtained information from Oulu University Hospital in which the great majority of patients with pituitary tumor from the four northernmost provinces of Finland are referred.…”

“…Notably, the last two studies obtained information from the Swedish Pituitary Registry and the Spanish acromegaly registry, respectively, and the possibility of under-reporting cannot be excluded. It should be also pointed out that the two studies from Iceland [6, 7] cover the same population and have a significant overlap in the sources of their data; this could sway the overall results and they should not be considered as independent from each other. In most studies, there is a rather equal distribution of prevalence between males and females, with the exception of Daly et al [4] and Agustsson et al [6], in which men showed prevalence rates twice as high as those of women.…”

“…Acral enlargement and coarse facial features are the most commonly described (78.8–85.7 % and 71.2–71.4 %, respectively) followed by headaches, macroglossia, increased sweating, arthralgias, increased skin thickness, snoring, tiredness and carpal tunnel syndrome [3, 7]. Hoskuldsdottir et al [7] also looked at the presence of comorbidities at diagnosis and reported hypertension in 48 %, diabetes mellitus in 13 %, impaired glucose tolerance in 19 %, heart failure in 10 % and coronary artery disease in 8 % of the cases. It should be noted however, that the reliability of the published information may be affected by the accuracy of documentation during the history taking and this needs to be taken into account when reviewing the frequency of the presenting signs and symptoms.…”

“…Hoskuldsdottir et al [7] also looked at the presence of comorbidities at diagnosis and reported hypertension in 48 %, diabetes mellitus in 13 %, impaired glucose tolerance in 19 %, heart failure in 10 % and coronary artery disease in 8 % of the cases. It should be noted however, that the reliability of the published information may be affected by the accuracy of documentation during the history taking and this needs to be taken into account when reviewing the frequency of the presenting signs and symptoms.…”

“…The duration of symptoms until diagnosis, which may in a large part be due to diagnostic delay, is still considerable, with median estimated intervals of 4.5–5 years; however, delays of 15 or even 25 years have been reported, in accord with the insidious onset of symptomatology (Table 3) [3, 4, 7, 11]. It should be noted though that the actual duration of the disease is not uniformly collected or determined and the relevant information, as provided by the patient, may be subjective and prone to recall bias.…”