Primary hyperparathyroidism: Increasing prevalence, social deprivation, and surgery

Area of Science:

• Endocrinology
• Public Health
• Epidemiology

Background:

• Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
• Understanding trends in PHPT incidence and treatment disparities is crucial for public health.
• Socioeconomic factors may influence PHPT diagnosis and management.

Purpose of the Study:

• To quantify the rising incidence of PHPT in Scotland.
• To examine the correlation between PHPT and socioeconomic deprivation.
• To investigate disparities in parathyroidectomy (PTX) rates based on deprivation.

Main Methods:

• Retrospective cohort study using Scottish Morbidity Records (SMR01) database.
• Inclusion of patients diagnosed with PHPT between 1986 and 2013.
• Analysis based on International Classification of Diseases codes for PHPT diagnosis.

Main Results:

• A significant increase in PHPT incidence was observed from 1986 to 2013 (p < 0.0001).
• A strong association was found between higher PHPT incidence and increased socioeconomic deprivation (p < 0.0001).
• Lower rates of parathyroidectomy (PTX) were significantly linked to higher deprivation levels (p < 0.001).

Conclusions:

• Increased PHPT incidence may stem from heightened awareness, improved diagnostics, and an aging population.
• Lower PTX rates in deprived populations could be attributed to comorbidities, age, and clinical uncertainty regarding benefits in asymptomatic cases.
• These findings highlight potential health inequalities in PHPT management that warrant further investigation.