Demographic and socioeconomic disparities of pituitary adenomas and carcinomas in the United States

• Published in: Journal of clinical neuroscience 2022-04, Vol.98, p.96-103
• Main Authors: Ghaffari – Rafi, Arash, Mehdizadeh, Rana, Ghaffari-Rafi, Shadeh, Castillo, Jose Antonio, Rodriguez-Beato, Freddie Yamel, Leon-Rojas, Jose
• Format: Article
• Language: English
• Subjects: Adenoma - epidemiology; Aged; Aged, 80 and over; Benign pituitary tumors; Carcinoma; Demographics; Disparities; Ethnicity; Female; Humans; Incidence; Male; Malignant pituitary tumors; Pituitary Neoplasms - epidemiology; Social Class; Socioeconomic; United States; United States - epidemiology
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2022.01.032

•Adenoma incidence rose between 1997 and 2016, while pituitary carcinoma incidence fell.•Adenoma incidence was greatest in urban centers, followed by rural and suburban.•Adenoma incidence was greatest amongst Blacks and Asians/Pacific Islanders.•Pituitary carcinoma incidence is falling for females and higher income patients. Growth of some pituitary tumors is driven by hormones which vary in concentration along the lines of patient socioeconomic status. Thus, pituitary tumors may exhibit disparities in incidence upon stratification by socioeconomic variables. Exploring for these disparities could provide direction in tumor etiology elucidation and identification of healthcare inequalities. To investigate pituitary adenoma and carcinoma incidence (per 100,000) with respect to sex, age, income, residence, and race/ethnicity, we searched the largest American administrative dataset (1997–2016), the National (Nationwide) Inpatient Sample (NIS), which surveys 20% of United States (US) discharges. Annual national incidence was 2.80 for adenomas and 0.046 for carcinomas. For adenomas, males had an incidence of 2.63, similar (p = 0.17) to females at 2.78; likewise, for carcinomas, males had a statistically equivalent (p = 0.24) incidence at 0.051 to females at 0.041. Amongst age groups, for adenomas incidence progressively rose, peaking 65–84 years old (6.12), before declining. For adenomas and carcinomas respectively, patients with low income had an incidence of 2.66 and 0.044, similar (p = 0.11; p = 0.72) to the 3.01 and 0.041 of middle/high income patients. Incidence was greatest for adenomas amongst urban centers (3.47), followed by rural (3.16) and suburban (3.01) communities. Examining race/ethnicity (p = 0.0000016), for adenomas, incidences amongst Blacks, Asian/Pacific Islanders, Hispanics, and Whites were as follows, respectively: 3.64, 2.57, 2.54, 2.44. Annually, incidence for adenomas was increasing (τ = 0.63, p = 0.00021), but decreasing (τ = −0.60, p = 0.00085) for carcinomas. Specifically, for carcinomas incidence was only decreasing for females and the middle/high income. In the US, time-enduring healthcare disparities were identified for pituitary adenomas and carcinomas, against the background of sociodemographic strata. For carcinomas, annual incidence was declining only for middle/high income patients and females, which supporting prior investigations that low income patients and males are experiencing barriers to definitive treatment for pituita