TY - JOUR
T1 - Rising burden of PRL-PitNETs
T2 - patterns across tumour sizes and incidentalomas
AU - Klit, Frederik Østergaard
AU - Nørgård, Sara Faartoft
AU - Berrett, Anna-Sofie Dam
AU - Rosendal, Christian
AU - Nikontovic, Amar
AU - Vestergaard, Peter
AU - Krogh, Jesper
AU - Stochholm, Kirstine
AU - Dal, Jakob
N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2025/11/26
Y1 - 2025/11/26
N2 - OBJECTIVE: Epidemiology of prolactin-secreting pituitary neuroendocrine tumours (PRL-PitNETs) remains scarce and inconsistent. It is a heterogeneous disease regarding age at onset, sex, and tumour characteristics. We aimed to assess temporal epidemiological trends in PRL-PitNETs.DESIGN: Cohort study, systematic review, and meta-analysis.METHODS: The cohort study comprised all PRL-PitNET patients in the North Denmark Region (2017-2022; N = 594 634), identified via ICD-10 coding (E22.1) or dopamine agonist treatment. Data included sex, age at diagnosis, adenoma size, and prolactin levels. For the systematic review, PubMed and Embase were searched (May 2025) for studies reporting ≥20 PRL-PitNETs. Extracted data comprised prevalence, incidence, age, and sex distributions. A random-effects meta-analysis was applied.RESULTS: The cohort included 245 patients: 167 microprolactinomas, 78 macroprolactinomas, and 20 incidentalomas. From 2017 to 2022, prevalence increased by 41% (95% CI: 25%-60%, +61 cases) overall, 42% (95% CI: 19%-68%, +39 cases) for microprolactinomas, 41% (95% CI: 19%-67%, +22 cases) for macroprolactinomas, and 57% (95% CI: 6%-132%, +7 cases) for incidentalomas. Overall incidence was 2.8 (95% CI: 2.2-3.5) per 100 000 person-years. The systematic review and meta-analysis (15 studies, 16 000 PRL-PitNET cases) showed an increasing PRL-PitNET prevalence and incidence, reaching 41 (95% PI: 12-89) per 100 000 persons and 2.3 (95% PI: 1.2-4.3) per 100 000 person-years, respectively; with a phenotypical shift towards more men (from 10%-20% to 20%-30%), macroprolactinomas (∼25 to ∼30%) and incidentalomas (∼6% to ∼10%) over the last two decades.CONCLUSION: PRL-PitNETs are increasingly prevalent, partly driven by a rising incidence of men and incidentalomas, suggesting a phenotypic shift and associated increase in clinical and healthcare burden.
AB - OBJECTIVE: Epidemiology of prolactin-secreting pituitary neuroendocrine tumours (PRL-PitNETs) remains scarce and inconsistent. It is a heterogeneous disease regarding age at onset, sex, and tumour characteristics. We aimed to assess temporal epidemiological trends in PRL-PitNETs.DESIGN: Cohort study, systematic review, and meta-analysis.METHODS: The cohort study comprised all PRL-PitNET patients in the North Denmark Region (2017-2022; N = 594 634), identified via ICD-10 coding (E22.1) or dopamine agonist treatment. Data included sex, age at diagnosis, adenoma size, and prolactin levels. For the systematic review, PubMed and Embase were searched (May 2025) for studies reporting ≥20 PRL-PitNETs. Extracted data comprised prevalence, incidence, age, and sex distributions. A random-effects meta-analysis was applied.RESULTS: The cohort included 245 patients: 167 microprolactinomas, 78 macroprolactinomas, and 20 incidentalomas. From 2017 to 2022, prevalence increased by 41% (95% CI: 25%-60%, +61 cases) overall, 42% (95% CI: 19%-68%, +39 cases) for microprolactinomas, 41% (95% CI: 19%-67%, +22 cases) for macroprolactinomas, and 57% (95% CI: 6%-132%, +7 cases) for incidentalomas. Overall incidence was 2.8 (95% CI: 2.2-3.5) per 100 000 person-years. The systematic review and meta-analysis (15 studies, 16 000 PRL-PitNET cases) showed an increasing PRL-PitNET prevalence and incidence, reaching 41 (95% PI: 12-89) per 100 000 persons and 2.3 (95% PI: 1.2-4.3) per 100 000 person-years, respectively; with a phenotypical shift towards more men (from 10%-20% to 20%-30%), macroprolactinomas (∼25 to ∼30%) and incidentalomas (∼6% to ∼10%) over the last two decades.CONCLUSION: PRL-PitNETs are increasingly prevalent, partly driven by a rising incidence of men and incidentalomas, suggesting a phenotypic shift and associated increase in clinical and healthcare burden.
KW - Humans
KW - Prolactinoma/epidemiology
KW - Pituitary Neoplasms/epidemiology
KW - Male
KW - Denmark/epidemiology
KW - Female
KW - Neuroendocrine Tumors/epidemiology
KW - Middle Aged
KW - Cohort Studies
KW - Adult
KW - Tumor Burden
KW - Incidental Findings
KW - Prevalence
KW - Aged
KW - Incidence
KW - Hyperprolactinaemia
KW - Epidemiology
KW - Prolactinoma
KW - Macroadenoma
KW - Incidentaloma
U2 - 10.1093/ejendo/lvaf254
DO - 10.1093/ejendo/lvaf254
M3 - Article
C2 - 41406354
SN - 0804-4643
VL - 193
SP - 745
EP - 761
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 6
ER -