Stable Incidence and Increasing Prevalence of Primary Hyperparathyroidism in a Population-based Study in Scotland

Abstract

Context: Previous studies, including our own, have demonstrated a highly variable incidence of primary hyperparathyroidism (PHPT) from year to year.

Objective: We planned to provide a current estimate of the incidence and prevalence of PHPT in a community-based study.

Methods: A population-based retrospective follow-up study was conducted in Tayside (Scotland) from 2007 to 2018. Record-linkage technology (demography, biochemistry, prescribing, hospital admissions, radiology, and mortality data) was used to identify all patients. Cases of PHPT were defined as those with at least 2 raised serum corrected calcium concentration CCA (> 2.55 mmol/L) and/or hospital admissions with PHPT diagnoses and/or surgery records with parathyroidectomy during the follow-up period. The number of prevalent and incident cases of PHPT per calendar year by age and sex were estimated.

Results: A total of 2118 people (72.3% female, mean age 65 years) were identified with an incident case of PHPT. The overall prevalence of PHPT over the 12 years of the study was 0.84% (95% CI, 0.68%-1.02%), steadily increasing from 0.71% in 2007 to 1.02% in 2018. From 2008, the incidence of PHPT was relatively stable from 4 to 6 cases per 10 000 person-years, declining from 11.5 per 10 000 person-years in 2007. The incidence varied from 0.59 per 10 000 person-years (95% CI, 0.40%-0.77%) for those aged 20 to 29 years, to 12.4 per 10 000 person-years (95% CI, 11.2%-13.3%) in those aged 70 to 79 years. Incidence of PHPT was 2.5 times higher in women than in men.

Conclusion: This study is the first showing a relatively steady annual incidence of PHPT at 4 to 6 per 10 000 person-years. This population-based study reports a PHPT prevalence of 0.84%.

Keywords: epidemiology; incidence; parathyroid gland; prevalence; primary hyperparathyroidism.

Figure 1.

Flowchart describing the study cohort's generation process and the patients finally included in the epidemiologic study. CCA, serum corrected calcium; PHPT, primary hyperparathyroidism.

Figure 2.

Incidence rates of primary hyperparathyroidism by age groups and sex.

Figure 3.

Incidence rates of primary hyperparathyroidism in Tayside (Scotland, UK) by calendar year (1997-2018). Thanks to Clinical Endocrinology for granting permission to use summary data for the period 1997 to 2006 (2).