title: Descriptive epidemiology of pituitary tumors in the United States, 2004-2009.
abstract: OBJECTIVE
  Pituitary tumors are abnormal growths that develop in the pituitary gland. The Central Brain Tumor Registry of the United States (CBTRUS) contains the largest aggregation of population-based data on the incidence of primary CNS tumors in the US. These data were used to determine the incidence of tumors of the pituitary and associated trends between 2004 and 2009.
  
  
  METHODS
  Using incidence data from 49 population-based state cancer registries, 2004-2009, age-adjusted incidence rates per 100,000 population for pituitary tumors with ICD-O-3 (International Classification of Diseases for Oncology, Third Edition) histology codes 8040, 8140, 8146, 8246, 8260, 8270, 8271, 8272, 8280, 8281, 8290, 8300, 8310, 8323, 9492 (site C75.1 only), and 9582 were calculated overall and by patient sex, race, Hispanic ethnicity, and age at diagnosis. Corresponding annual percent change (APC) scores and 95% confidence intervals were also calculated using Joinpoint to characterize trends in incidence rates over time. Diagnostic confirmation by subregion of the US was also examined. The overall annual incidence rate increased from 2.52 (95% CI 2.46-2.58) in 2004 to 3.13 (95% CI 3.07-3.20) in 2009. Associated time trend yielded an APC of 4.25% (95% CI 2.91%-5.61%). When stratifying by patient sex, the annual incidence rate increased from 2.42 (95% CI 2.33-2.50) to 2.94 (95% CI 2.85-3.03) in men and 2.70 (95% CI 2.62-2.79) to 3.40 (95% CI 3.31-3.49) in women, with APCs of 4.35% (95% CI 3.21%-5.51%) and 4.34% (95% CI 2.23%-6.49%), respectively. When stratifying by race, the annual incidence rate increased from 2.31 (95% CI 2.25-2.37) to 2.81 (95% CI 2.74-2.88) in whites, 3.99 (95% CI 3.77-4.23) to 5.31 (95% CI 5.06-5.56) in blacks, 1.77 (95% CI 1.26-2.42) to 2.52 (95% CI 1.96-3.19) in American Indians or Alaska Natives, and 1.86 (95% CI 1.62-2.13) to 2.03 (95% CI 1.80-2.28) in Asians or Pacific Islanders, with APCs of 3.91% (95% CI 2.88%-4.95%), 5.25% (95% CI 3.19%-7.36%), 5.31% (95% CI -0.11% to 11.03%), and 2.40% (95% CI -3.20% to 8.31%), respectively. When stratifying by Hispanic ethnicity, the annual incidence rate increased from 2.46 (95% CI 2.40-2.52) to 3.03 (95% CI 2.97-3.10) in non-Hispanics and 3.12 (95% CI 2.91-3.34) to 4.01 (95% CI 3.80-4.24) in Hispanics, with APCs of 4.15% (95% CI 2.67%-5.65%) and 5.01% (95% CI 4.42%-5.60%), respectively. When stratifying by age at diagnosis, the incidence of pituitary tumor was highest for those 65-74 years old and lowest for those 15-24 years old, with corresponding overall age-adjusted incidence rates of 6.39 (95% CI 6.24-6.54) and 1.56 (95% CI 1.51-1.61), respectively.
  
  
  CONCLUSIONS
  In this large patient cohort, the incidence of pituitary tumors reported between 2004 and 2009 was found to increase. Possible explanations for this increase include changes in documentation, changes in the diagnosis and registration of these tumors, improved diagnostics, improved data collection, increased awareness of pituitary diseases among physicians and the public, longer life expectancies, and/or an actual increase in the incidence of these tumors in the US population.
authors.affiliation: Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, University Hospitals Case Medical Center;
authors.forename: Haley
authors.initials: H
authors.lastname: Gittleman
authors.forename: Quinn T
authors.initials: QT
authors.lastname: Ostrom
authors.forename: Paul D
authors.initials: PD
authors.lastname: Farah
authors.forename: Annie
authors.initials: A
authors.lastname: Ondracek
authors.forename: Yanwen
authors.initials: Y
authors.lastname: Chen
authors.forename: Yingli
authors.initials: Y
authors.lastname: Wolinsky
authors.forename: Carol
authors.initials: C
authors.lastname: Kruchko
authors.forename: Justin
authors.initials: J
authors.lastname: Singer
authors.forename: Varun R
authors.initials: VR
authors.lastname: Kshettry
authors.forename: Edward R
authors.initials: ER
authors.lastname: Laws
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Sloan
authors.forename: Warren R
authors.initials: WR
authors.lastname: Selman
authors.forename: Jill S
authors.initials: JS
authors.lastname: Barnholtz-Sloan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000453:epidemiology* / Q000208:ethnology*; D044469:Racial Groups; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: AIAN = American Indian or Alaska Native; APC = annual percentage change; API = Asian or Pacific Islander; CBTRUS; CBTRUS = Central Brain Tumor Registry of the United States; CDC = Centers for Disease Control and Prevention; ICD-O-3 = International Classification of Diseases for Oncology, Third Edition; NPCR = National Program of Cancer Registries; SEER = Surveillance, Epidemiology, and End Results; epidemiology; incidence trend; overall incidence; pituitary surgery; pituitary tumor