Descriptive epidemiology of pituitary tumors in the United States, 2004–2009

Clinical article

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  • 5 Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, University Hospitals Case Medical Center;
  • 1 Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine;
  • 3 Case Western Reserve University;
  • 6 Department of Neurosurgery, Neurological and Taussig Cancer Institute, Cleveland Clinic, Cleveland;
  • 4 The Ohio State University, Columbus, Ohio;
  • 2 Central Brain Tumor Registry of the United States, Hinsdale, Illinois; and
  • 7 Department of Neurological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Object

Pituitary tumors are abnormal growths that develop in the pituitary gland. The Central Brain Tumor Registry of the United States (CBTRUS) contains the largest aggregation of population-based data on the incidence of primary CNS tumors in the US. These data were used to determine the incidence of tumors of the pituitary and associated trends between 2004 and 2009.

Methods

Using incidence data from 49 population-based state cancer registries, 2004–2009, age-adjusted incidence rates per 100,000 population for pituitary tumors with ICD-O-3 (International Classification of Diseases for Oncology, Third Edition) histology codes 8040, 8140, 8146, 8246, 8260, 8270, 8271, 8272, 8280, 8281, 8290, 8300, 8310, 8323, 9492 (site C75.1 only), and 9582 were calculated overall and by patient sex, race, Hispanic ethnicity, and age at diagnosis. Corresponding annual percent change (APC) scores and 95% confidence intervals were also calculated using Joinpoint to characterize trends in incidence rates over time. Diagnostic confirmation by subregion of the US was also examined.

Results

The overall annual incidence rate increased from 2.52 (95% CI 2.46–2.58) in 2004 to 3.13 (95% CI 3.07–3.20) in 2009. Associated time trend yielded an APC of 4.25% (95% CI 2.91%–5.61%). When stratifying by patient sex, the annual incidence rate increased from 2.42 (95% CI 2.33–2.50) to 2.94 (95% CI 2.85–3.03) in men and 2.70 (95% CI 2.62–2.79) to 3.40 (95% CI 3.31–3.49) in women, with APCs of 4.35% (95% CI 3.21%–5.51%) and 4.34% (95% CI 2.23%–6.49%), respectively. When stratifying by race, the annual incidence rate increased from 2.31 (95% CI 2.25–2.37) to 2.81 (95% CI 2.74–2.88) in whites, 3.99 (95% CI 3.77–4.23) to 5.31 (95% CI 5.06–5.56) in blacks, 1.77 (95% CI 1.26–2.42) to 2.52 (95% CI 1.96–3.19) in American Indians or Alaska Natives, and 1.86 (95% CI 1.62–2.13) to 2.03 (95% CI 1.80–2.28) in Asians or Pacific Islanders, with APCs of 3.91% (95% CI 2.88%–4.95%), 5.25% (95% CI 3.19%–7.36%), 5.31% (95% CI –0.11% to 11.03%), and 2.40% (95% CI –3.20% to 8.31%), respectively. When stratifying by Hispanic ethnicity, the annual incidence rate increased from 2.46 (95% CI 2.40–2.52) to 3.03 (95% CI 2.97–3.10) in non-Hispanics and 3.12 (95% CI 2.91–3.34) to 4.01 (95% CI 3.80–4.24) in Hispanics, with APCs of 4.15% (95% CI 2.67%–5.65%) and 5.01% (95% CI 4.42%–5.60%), respectively. When stratifying by age at diagnosis, the incidence of pituitary tumor was highest for those 65–74 years old and lowest for those 15–24 years old, with corresponding overall age-adjusted incidence rates of 6.39 (95% CI 6.24–6.54) and 1.56 (95% CI 1.51–1.61), respectively.

Conclusions

In this large patient cohort, the incidence of pituitary tumors reported between 2004 and 2009 was found to increase. Possible explanations for this increase include changes in documentation, changes in the diagnosis and registration of these tumors, improved diagnostics, improved data collection, increased awareness of pituitary diseases among physicians and the public, longer life expectancies, and/or an actual increase in the incidence of these tumors in the US population.

Abbreviations used in this paper:AIAN = American Indian or Alaska Native; APC = annual percentage change; API = Asian or Pacific Islander; CBTRUS = Central Brain Tumor Registry of the United States; CDC = Centers for Disease Control and Prevention; ICD-O-3 = International Classification of Diseases for Oncology, Third Edition; NPCR = National Program of Cancer Registries; SEER = Surveillance, Epidemiology, and End Results.

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Contributor Notes

Address correspondence to: Jill Barnholtz-Sloan, Ph.D., Case Comprehensive Cancer Center, CWRU School of Medicine, 11100 Euclid Ave., Wearn 152, Cleveland, OH 44106-5065. email: jsb42@case.edu.

Please include this information when citing this paper: published online June 13, 2014; DOI: 10.3171/2014.5.JNS131819.

  • 1

    Asa SL, & Ezzat S: The pathogenesis of pituitary tumours. Nat Rev Cancer 2:836849, 2002

  • 2

    Ciccarelli A, , Daly AF, & Beckers A: The epidemiology of prolactinomas. Pituitary 8:36, 2005

  • 3

    Daly AF, , Rixhon M, , Adam C, , Dempegioti A, , Tichomirowa MA, & Beckers A: High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab 91:47694775, 2006

    • Search Google Scholar
    • Export Citation
  • 4

    Dolecek TA, , Propp JM, , Stroup NE, & Kruchko C: CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro Oncol 14:Suppl 5 v1v49, 2012. (Erratum in Neuro Oncol 15:646–647, 2013)

    • Search Google Scholar
    • Export Citation
  • 5

    Ezzat S, , Asa SL, , Couldwell WT, , Barr CE, , Dodge WE, & Vance ML, : The prevalence of pituitary adenomas: a systematic review. Cancer 101:613619, 2004

    • Search Google Scholar
    • Export Citation
  • 6

    Fernandez A, , Karavitaki N, & Wass JAH: Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol (Oxf) 72:377382, 2010

    • Search Google Scholar
    • Export Citation
  • 7

    Hemminki K, , Försti A, & Ji J: Incidence and familial risks in pituitary adenoma and associated tumors. Endocr Relat Cancer 14:103109, 2007

    • Search Google Scholar
    • Export Citation
  • 8

    McDowell BD, , Wallace RB, , Carnahan RM, , Chrischilles EA, , Lynch CF, & Schlechte JA: Demographic differences in incidence for pituitary adenoma. Pituitary 14:2330, 2011

    • Search Google Scholar
    • Export Citation
  • 9

    Melmed S: Pathogenesis of pituitary tumors. Nat Rev Endocrinol 7:257266, 2011

  • 10

    Morris Z, , Whiteley WN, , Longstreth WT Jr, , Weber F, , Lee YC, & Tsushima Y, : Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 339:b3016, 2009

    • Search Google Scholar
    • Export Citation
  • 11

    Nilsson B, , Gustavasson-Kadaka E, , Bengtsson BA, & Jonsson B: Pituitary adenomas in Sweden between 1958 and 1991: incidence, survival, and mortality. J Clin Endocrinol Metab 85:14201425, 2000

    • Search Google Scholar
    • Export Citation
  • 12

    Ónnestam L, , Berinder K, , Burman P, , Dahlqvist P, , Engström BE, & Wahlberg J, : National incidence and prevalence of TSH-secreting pituitary adenomas in Sweden. J Clin Endocrinol Metab 98:626635, 2013

    • Search Google Scholar
    • Export Citation
  • 13

    Popovic V, , Damjanovic S, , Micic D, , Nesovic M, , Djurovic M, & Petakov M, : Increased incidence of neoplasia in patients with pituitary adenomas. Clin Endocrinol (Oxf) 49:441445, 1998

    • Search Google Scholar
    • Export Citation
  • 14

    Raappana A, , Koivukangas J, , Ebeling T, & Pirilä T: Incidence of pituitary adenomas in Northern Finland in 1992–2007. J Clin Endocrinol Metab 95:42684275, 2010

    • Search Google Scholar
    • Export Citation
  • 15

    Sivakumar W, , Chamoun R, , Nguyen V, & Couldwell WT: Incidental pituitary adenomas. Neurosurg Focus 31:6 E18, 2011

  • 16

    Vernooij MW, , Ikram MA, , Tanghe HL, , Vincent AJ, , Hofman A, & Krestin GP, : Incidental findings on brain MRI in the general population. N Engl J Med 357:18211828, 2007

    • Search Google Scholar
    • Export Citation

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