Pituitary adenomas in Sweden between 1958 and 1991: Incidence, survival, and mortality

The objective of the present study was to determine the incidence of pituit ary adenomas (PAs) and the associated rates and causes of mortality in a la rge population. The study population comprised 2279 patients (1010 women an d 1269 men) of all individuals (n = 3321) with pituitary tumors included in the Swedish Cancer Registry between 1958 and 1991. The mean age (+/-SD) at diagnosis was 52.3 +/- 15.7 yr. The age-standardized incidence of PA incre ased significantly from approximately 6 cases/million inhabitants in 1958 t o 11 cases/million in 1991. The age-specific incidence peaked between 60-70 yr of age in both sexes. Excess mortality was found in the study populatio n. The total number of deaths was 842. The standardized mortality ratio (SM R) for the study population was 2.0. The SMR for women (2.3) was significan tly (P < 0.01) higher than that for men (1.9). Cardiovascular diseases were the most common cause of mortality among patients, accounting for 346 deat hs (SMR, 1.6). The difference between the sexes was significant (men, 1.4; women, 1.8; P < 0.05). Cerebrovascular death occurred in 97 patients (SMR, 2.4), with no significant difference between men (SMR, 2.5) and women (SMR, 2.2). Excess mortality was also observed for tumors, endocrine diseases, a nd gastrointestinal diseases. These finding; suggest that the annual incide nce of PA is increasing. Possible explanations are improved diagnostic skil l and/or increased awareness of pituitary diseases among physicians. Howeve r, a real increase in the incidence of PA cannot he ruled out.