title: Incidence of Cushing's syndrome and Cushing's disease in commercially-insured patients <65 years old in the United States.
abstract: OBJECTIVE
  To estimate the incidence of Cushing's syndrome (CS) and Cushing's disease (CD) in the US.
  
  
  METHODS
  MarketScan Commercial database 2007-2010 (age <65 years) was used. CS patients were defined with ≥2 claims of CS diagnosis, while CD patients were defined with CS plus a benign pituitary adenoma diagnosis or hypophysectomy in the same calendar year. Annual incidence was calculated by dividing the number of CS or CD cases by the total number of members with the same enrollment requirement during the calendar years.
  
  
  RESULTS
  CS incidence rates per million person-years were 48.6 in 2009 and 39.5 in 2010. The lowest rates of CS were in ≤17-year-olds and highest rates were in 35 to 44-year-olds. CD incidence rates were 7.6 in 2009 and 6.2 in 2010. The lowest rates of CD were in ≤17-year-olds and highest rates were in 18 to 24-year-olds. The rates varied by sex (2.3-2.7 in males, 9.8-12.1 in females). In females, lowest rates ranged 2.5-4.0 in ≤17-year-olds and highest 16.7-27.2 in 18-24 year olds. In males, there were too few cases to report estimates by age.
  
  
  CONCLUSIONS
  In the first large US-based study, the annual incidence of CS in individuals <65 years old was nearly 49 cases per million, substantially higher than previous estimates, which were based primarily on European data. Using similar methods, we estimated the incidence of CD at nearly 8 cases per million US population. These estimates, if confirmed in other epidemiologic databases, represent a new data reference in these rare conditions.
authors.affiliation: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA, 90212, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Broder
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Neary
authors.forename: Eunice
authors.initials: E
authors.lastname: Chang
authors.forename: Dasha
authors.initials: D
authors.lastname: Cherepanov
authors.forename: William H
authors.initials: WH
authors.lastname: Ludlam
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003132:Commerce; D003430:Cross-Sectional Studies; D003480:Cushing Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult