UK practice on incidentally detected non-functioning pituitary microadenomas: analysis of two national surveys during a 12-year interval
Authors' conclusion
Diagnostic and management approaches for microNFPAs have evolved in the UK. Biochemical investigations are performed in accord with consensus guidelines, though many clinicians perform annual biochemical surveillance without tumour growth/symptoms. A small number of clinicians request imaging beyond 5 years, but the frequency of imaging intervals until discharge remains variable. Robust evidence on the long-term natural history of microNFPAs is necessary to unify clinician approach.
Study context
- Population
- UK clinicians managing presumed non-functioning pituitary microadenomas (microNFPAs), surveys advertised through Society for Endocrinology UK
- Participants
- 150 vs 214
- Exposure
- 2021–2022 survey vs 2009–2010 survey
- 2021 surveyn = 150
- 2009 surveyn = 214reference
- Outcome
- Baseline biochemical investigations
- Follow-up
- Baseline
Methodological detailstwo national online surveys of clinicians, 2009-2010 and 2021-2022
- Two national online surveys of clinicians
- 2009-2010 and 2021-2022
Main finding
As reported in the abstract
IGF-1 measured
Morning cortisol
P < 0.001
GH
P = 0.002
24 h UFC
P < 0.0001
Dynamic adrenal reserve assessment
- 2021 survey vs 2009 survey: P < 0.001 — IGF-1; more likely in 2021
- 2021 survey vs 2009 survey: P < 0.001 — dynamic adrenal reserve; less likely in 2021
Observational data: associations, not effects.
Further findings
Response rates
Stop imaging at or before 3 years · more likely in 2021
P < 0.001
Continue imaging beyond 5 years · more likely in 2009
P < 0.001
| Outcome | 2021 survey | 2009 survey | P value |
|---|---|---|---|
| Annual reassessment of pituitary function until discharge (no tumour growth/symptoms) | 47.2% | — not stated in the abstract | |
| Stop imaging at or before 5 yearsMore likely in 2021 | 86.6.% | 72.9% | P = 0.002 |
— not stated in the abstract
Imaging frequency/intervals
- Notable variability in both surveys
Original publication
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