title: Primary hyperparathyroidism: Increasing prevalence, social deprivation, and surgery.
abstract: OBJECTIVE
  To measure the increasing incidence of primary hyperparathyroidism (PHPT) in Scotland, to determine the relationship between PHPT and deprivation, and to investigate the relationship between parathyroidectomy (PTX) and social deprivation.
  
  
  METHODS
  We retrospectively identified a cohort of patients diagnosed with PHPT between 1986 and 2013 from the Scottish Morbidity Records (SMR01) database. The diagnosis of PHPT was made in accordance with the International Classification of Diseases code.
  
  
  RESULTS
  Between the years 1986 and 2013, 4002 patients were diagnosed with PHPT. There was a significant increase in the incidence of PHPT in this period (p < 0.0001), an association between the incidence of PHPT and deprivation (p < 0.0001) plus an association between a lower rate of PTX and deprivation (p < 0.001).
  
  
  CONCLUSIONS
  The increase in incidence of PHPT may be due to a combination of increased awareness of PHPT, easier diagnosis, and an ageing population. The lower rate of PTX in relation to deprivation may reflect comorbidities, age, and uncertainty about the long-term benefits of PTX in asymptomatic patients.
authors.affiliation: a Department of General Medicine , University Hospital Ayr, NHS Ayrshire & Arran , Ayr , Edinburgh , Scotland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Collier
authors.affiliation: a Department of General Medicine , University Hospital Ayr, NHS Ayrshire & Arran , Ayr , Edinburgh , Scotland.
authors.forename: Mark
authors.initials: M
authors.lastname: Portelli
authors.affiliation: a Department of General Medicine , University Hospital Ayr, NHS Ayrshire & Arran , Ayr , Edinburgh , Scotland.
authors.forename: Sujoy
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: b eData Research & Innovation Service , Information Services Division (ISD), NHS National Services , Ayr , Edinburgh , Scotland.
authors.forename: Sian
authors.initials: S
authors.lastname: Nowell
authors.affiliation: b eData Research & Innovation Service , Information Services Division (ISD), NHS National Services , Ayr , Edinburgh , Scotland.
authors.forename: David
authors.initials: D
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D012923:Social Class
keywords: Hyperparathyroidism; parathyroidectomy; prevalence; social deprivation