Epidemiology

Primary hyperparathyroidism (PHPT) is a relatively common disorder affecting 1 in 500 women and 1 in 2000 men aged over 40 years.[8]

In the 1970s, the incidence of PHPT in developed countries rose dramatically with the onset of widespread routine use of multi-channel analysers that included measurements of serum calcium levels.​[9]​​ The estimated incidence in the US between 1998 and 2010 was 50 per 100,000 person-years.[10][11] In the US, the overall age‐adjusted prevalence rate of PHPT in 2010 was estimated at 233 per 100,000 in women and 85 per 100,000 in men.[10]​ The incidence and prevalence of PHPT is highest in black people compared to other racial groups.[10]

While the condition may affect all age groups, it is uncommon in the first two decades of life, in the absence of inherited syndromes. It is most commonly found in women between 50 and 60 years of age, with a two to three times greater incidence in women compared with men.[2][6]​​

Globally, the presentation of PHPT varies greatly. In the US and Europe, most (80%) patients present with asymptomatic disease, but in resource-poor nations, around 80% of patients present with symptoms.[12][6][13]​​​ In countries where routine biochemical screening is less common, patients with PHPT are likely to present with symptomatic disease at a younger age and with more severe clinical and biochemical abnormalities.​​​[13] The true prevalence of PHPT is unknown, as many patients with documented hypercalcaemia never go on to be evaluated for possible hyperparathyroidism.[14][15][16]​​​​​​

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