Increase in presentations and procedure rates for hyperparathyroidism in Northern Sydney and New South Wales.
OBJECTIVE
To examine changes in presentation of primary hyperparathyroidism and rates of parathyroidectomy in Northern Sydney (the Northern Sydney Area Heath Service) and New South Wales (NSW).


METHODS
Retrospective case series January 1962 - December 2001 and audit of the NSW Department of Health inpatient database (1993-1999).


METHODS
University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital.


METHODS
1613 patients undergoing parathyroidectomy during the study period.


METHODS
Age-standardised parathyroidectomy rates and indications for surgical intervention.


RESULTS
The age-standardised rates of parathyroidectomy for primary hyperparathyroidism in women have increased significantly in Northern Sydney from 0.14 cases per 100,000 in 1976 to 7.7 cases per 100,000 in 1996 (P < 0.001). In NSW there has been an increase in parathyroidectomy rates in women from 5.1 cases per 100,000 in 1993 to 12.3 cases per 100,000 in 1998 (P < 0.001). Osteoporosis was the most common overall indication for surgery in Northern Sydney, accounting for 27% of all cases. The proportion of cases presenting with osteoporosis increased significantly from 4% in 1962-1980 to 34% over the past decade (P < 0.001).


CONCLUSIONS
The rate of parathyroidectomy procedures has increased markedly in Northern Sydney and in NSW. The investigation of osteoporosis has led to the diagnosis of primary hyperparathyroidism in an increasing proportion of cases and has contributed to the growing surgical referral rates.
Sywak
Mark S
MS
Department of Community Medicine and Public Health, University of Calgary, Calgary, Alberta, Canada.
Robinson
Bruce G
BG
Clifton-Bligh
Phillip
P
Reeve
Tom S
TS
Barraclough
Bruce H
BH
Fick
Gordon H
GH
Delbridge
Leigh W
LW
D000328:Adult; D017677:Age Distribution; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D016105:Parathyroidectomy / Q000706:statistics & numerical data* / Q000639:trends; D012189:Retrospective Studies; D017678:Sex Distribution