Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2009) 20 HTC2

ECE2009 Clinical Highlights Hot topics: Clinical (5 abstracts)

Primary hyperparathyroidism (Nationwide cohort study): an increased risk of cancer and decreased survival

Sujoy Ghosh 1 , Andrew Collier 1 , David Clark 2 , Tarik Elhadd 1 & Iqbal Malik 1


1NHS Ayrshire & Arran Information Services Division, The Ayr Hospital, NHS National Services Scotland, Scotland, UK; 2Information Services Division, NHS Ayrshire & Arran, NHS National Services Scotland, Scotland, UK.


Introduction:

  • The incidence of primary hyperparathyroidism (PHPT) is ~3.5/100 000 per year
  • The incidence is on the rise due to increase in ‘routine biochemical testing’
  • Has been thought to be a ‘relatively harmless’ disorder.
  • Some patients tend to undergo surgery, while others are conservatively treated and most followed up for a short period before discharge from follow up.

Aims:

  • Determine if risk of cancer is increased in patients with primary hyperparathyroidism (PHPT)
  • Determine if mortality is increased in patients with primary hyperparathyroidism.

Methodology:

  • A cohort of patients with PHPT between 1981 and 2007 was identified from the Scottish morbidity records and linked to the Scottish cancer registry and Scottish mortality records.
  • Patients with pre-existing cancers (or developing cancer within one year of diagnosis of PHPT) were excluded from the analysis of subsequent cancer risks.
  • The prevalence of new cancers and deaths was identified in these patients.
  • The results were then compared with the risk of cancer and mortality in the general population living in Scotland.

Outcome/results:

  • Total number of patients diagnosed with PHPT: 3039
  • Females: 2350 (77.3%), Males: 689 (22.7%)
  • Mean age of patients: 63.5 years
  • Person years at risk of cancer: 22 710
  • New cases of cancer: 440/2706
  • Standardised incidence rate of cancer: (SIR): 2.026, 95% CI (1.841–2.224), P<0.001
  • Person years at risk of death: 24 186
  • Number of deaths: 1601
  • Standardised Incidence Rate of deaths: (SIR): 3.085, 95% CI (2.936–3.240) P<0.001

Conclusions:

  • Individuals with PHPT have a two fold increased risk of developing subsequent cancer and a three fold increased risk of death as compared to general population.
  • The findings of this study have enormous implications for management and follow up of patients diagnosed with primary hyperparathyroidism.

Article tools

My recent searches

No recent searches.