title: Incidence and prevalence of clinically relevant pituitary adenomas: retrospective cohort study in a Health Management Organization in Buenos Aires, Argentina.
abstract: OBJECTIVE
  The main purpose of this study was to estimate the incidence rate and prevalence of clinically relevant pituitary adenomas (PAs) within the Hospital Italiano Medical Care Program (HIMCP), a well-defined population of 150,000 members living in the urban and suburban area of the city of Buenos Aires. We defined clinically relevant PAs as those associated with endocrine dysfunction and/or mass effect.
  
  
  METHODS
  A retrospective open cohort study was conducted, including all members of the HIMCP over 18 years old, with active memberships during the period of the study, from January 1st 2003, to January 1, 2014. The incidence rates (IRs) were standardized (SIR) to the World Health Organization (WHO) 2000 standard population and were expressed per 100,000 members/year. Prevalence was estimated at January 1, 2014, and was expressed per 100,000 persons. The clinical records have been electronically managed since 2001. All lab and imaging studies were done in-house.
  
  
  RESULTS
  The overall SIR was 7.39/100,000/year (95% CI 4.47-10.31). Female patients had a specific IR significantly higher than male patients (5.85 vs.1.54) and represented 73% of the affected members. Regarding tumor size, 61.4% were microadenomas, and the mean age at diagnosis was 46.4 years. Prolactinomas had the highest SIR (5.41), followed by acromegaly (Acro) and non-functioning adenomas (NFAs) with overlapping 95% CIs (0.44-1.41 and 0.31-0.99, respectively). Microprolactinomas were more frequent in female (72.6%) (p < 0.01) and younger members (38 vs.60 years; p < 0.04). The overall prevalence rate was 97.76/100,000. Prolactinomas had the highest prevalence (56.29), followed by NFAs (21.48), Acro (14.07) and CD (5.93).
  
  
  CONCLUSIONS
  Our results demonstrate that clinically relevant PAs are more common than usually suspected, especially prolactinomas and growth-hormone secreting PAs. These data highlight the need to increase the awareness of PAs, thereby enabling early diagnosis and treatment.
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Patricia Fainstein
authors.initials: PF
authors.lastname: Day
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Monica Graciela
authors.initials: MG
authors.lastname: Loto
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Mariela
authors.initials: M
authors.lastname: Glerean
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: María Fabiana Russo
authors.initials: MF
authors.lastname: Picasso
authors.affiliation: Department of Endocrinology and Nuclear Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Soledad
authors.initials: S
authors.lastname: Lovazzano
authors.affiliation: Research in Internal Medicine Unit, Department of Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Diego Hernán
authors.initials: DH
authors.lastname: Giunta
mesh_terms: D000236:Adenoma / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D015175:Prolactinoma / Q000453:epidemiology*; D012189:Retrospective Studies; D017678:Sex Distribution; D055815:Young Adult