Trends in Pituitary Adenoma Incidence: Population-Based Study, 1989–2019

Introduction: Pituitary adenomas are one of the most common intrinsic brain tumors. Advanced imaging and endocrinologic screening have led to improved diagnosis and disease surveillance, leading to increases in surgical and radiation interventions. However, there are minimal population-based studies on pituitary adenoma incidence and prevalence within the past three decades, creating a gap in our collective, longitudinal appreciation for disease occurrence, and associated demographics.

Methods: Retrospective review of all patients with pituitary adenoma during the study period, from 1989 to 2019. Patient source was the Rochester Epidemiology Project (REP), a population-based patient registry incorporating 27 counties in south eastern Minnesota, with approximately 97% capture. Diagnostic codes for pituitary adenoma and apoplexy were used to identify cases and years of diagnosis, which in turn were used to calculate incidence rates over time.

Results: Initial REP screen identified 752 records with confirmed pituitary adenoma. Simple annual incidence during the study period ranged from 4 to 46 new cases, or 5 to 38 new cases per 100,000 population. A linear trend over time was noted with respect to increasing pituitary adenoma incidence, which was preserved after adjusting for changes in sample population census (R ² = 0.67, R ² = 0.44; [Fig. 1A, B]). Trends in apoplexy incidence mirrored those of the overall pituitary adenoma population; however, increased incidence variability was noted, as well as weaker linear correlation with time, attributable to the smaller event rate and sample size.

Conclusion: Pituitary adenoma incidence has increased over time. The current population-based study provides robust support for this previously reported finding, with novel data including calculation of the first population-based incidence rate trends. Trends in apoplexy incidence appear to mirror overall changes in disease incidence. Given the parallel and correlated increases in incidence density and incidental diagnosis, expanding access to advanced medical imaging is the most likely driver of changes in perceived disease burden.

Fig. 1

Publication History

Article published online:
12 February 2021