Endocrine Abstracts

JOINT1829

Objective: Epidemiological data is essential for assessing disease health burden. The aim of the study was to explore longitudinal trends in incidence and prevalence of pituitary neuroendocrine tumours (PitNET) and analyse these variations.

Methods: Population based retrospective analysis on all patients diagnosed between 2000 and 2024 in a well-defined population, the Maltese islands. Main outcome measures: Prevalence Rate 2024; Standardised Incidence rates (SIR) 2000-2024 together with other relevant descriptive epidemiological statistics.

Results: From a total of 987 patients that were diagnosed with PitNETs, 880 patients were alive at end of 2024 giving an overall prevalence of 156.2/100,000 whilst 859 patients had presented between 2000 and 2024 providing an overall SIR of 7.04/100,000/year. Median age at presentation was 43 years (IQR 32-58). 28.2% had suprasellar extension with 19.3% having chiasmal compression. Cavernous sinus invasion was evident in 17.6% of patients. 7.8% of the cohort passed away. Interestingly, no evidence of increased mortality was observed in this cohort of patients when compared to the general population with a standardised mortality ratio (SMR) of 0.68 (95%CI 0.52-0.84). Non-functional PitNETs (NFPitNET) constituted 55.1% of the cohort, whilst 39.0% were prolactinomas, 7.1% were somatotropinomas and 2.7% were corticotropinomas giving rise to an overall SIR of 3.35, 3.01, 0.46, 0.20/100,000/year respectively. Males accounted for 37.3% of the entire cohort, giving rise to a SIR of 4.67/100,000/year compared to 9.72/100,000/year in females. Macroadenomas constituted 36.8% of the tumours with a SIR of 2.25/100,000/year. Furthermore 3.5% of the whole cohort were giant PitNETs (> 40 mm) resulting in a SIR of 0.20/100,000/year. On further analysis, there was an increase in the rate of all PitNETs from 4.26/100,000/year between 2000-2005 to a rate of 10.90/100,000/year in 2020-2024. In males SIR increased from 2.00/100,000/year to 8.16/100,000/year during the same time frame while in females it increased from 6.66/100,000/year to 14.36/100,000/year. The SIR for prolactinomas increased from 2.26/100,000/year to 3.98/100,000/year while for NFPitNETs from 1.58/100,000/year to 6.20/100,000/year for the same time periods. For PitNETs specifically greater than 30 mm in diameter at presentation, notably the SIR increase was relatively smaller, from 0.44 to 0.58/100,000/year when comparing the same time periods.

Conclusion: This study provides in depth and contemporary analysis of epidemiological trends of PitNETs in a well-defined population. Incidence rates appear to be increasing over time and in general, the survival outcomes of patients with these tumours appears to be quite favourable.