The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965-1992

Area of Science:

• Endocrinology
• Epidemiology
• Public Health

Background:

• Routine serum calcium measurement introduction in the 1970s led to a surge in primary hyperparathyroidism diagnoses.
• The study examines trends in primary hyperparathyroidism incidence since the mid-1970s.

Purpose of the Study:

• To evaluate the incidence trends of primary hyperparathyroidism.
• To understand the epidemiological changes in primary hyperparathyroidism since the mid-1970s.

Main Methods:

• Population-based descriptive study conducted in Rochester, Minnesota, from 1965 to 1992.
• Identified definite cases of primary hyperparathyroidism using the Rochester Epidemiology Project medical records linkage system.
• Calculated age- and sex-adjusted incidence rates standardized to the 1990 US white population.

Main Results:

• Incidence rose from 15 to 112 cases per 100,000 person-years after routine calcium testing began in 1974.
• Despite improved case ascertainment, incidence significantly decreased to 4 cases per 100,000 person-years by 1992.
• Complications and survival rates remained unchanged, with no significant change in maximum serum calcium levels.

Conclusions:

• The observed progressive decrease in primary hyperparathyroidism incidence is unexpected.
• This trend suggests a significant shift in the disease's epidemiology.