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Population-based incidence of conjunctival tumours in Olmsted County, Minnesota.

ABSTRACT: AIM:To determine population-based incidence of conjunctival tumours in Olmsted County, Minnesota. METHODS:The Rochester Epidemiology Project medical record linkage system was used to identify patients with conjunctival tumours in Olmsted County (1 January 1980 to 31 December 2015). Records were reviewed for demographics, types of tumours, histopathology, treatment and clinical course. Incidence rate of all tumours was calculated per 1 000 000 person-years. Poisson regression analysis was used to assess changes in incidence over time. RESULTS:There were 504 patients with conjunctival tumours, giving an age-adjusted and sex-adjusted incidence rate of 125 per 1 000 000 (CI 113.5 to 135.5). Incidence increased over time (P<0.001). Most tumours (474, 94%) were benign. Of benign lesions, melanocytic lesions accounted for the majority (431, 86%), with adjusted incidence rates of 10.8 (CI 7.7 to 13.9) for complexion-associated melanosis, 49.7 (CI 42.9 to 56.6) for nevus and 44.1 (37.5-50.8) for primary acquired melanosis. Malignant lesions were rare (30, 6%) with 6 cases of melanoma, 21 cases of ocular surface squamous neoplasia (OSSN), 1 case of Langerhans cell histiocytosis and 2 cases of lymphoma. Adjusted incidence rates of conjunctival melanoma and OSSN were 1.5 (CI 0.3 to 2.8) and 6.1 (CI 3.5 to 8.7), respectively. Outcomes for melanoma (mean follow-up 14 years, range 0-34) and OSSN (mean follow-up 4 years, range 0-24) were favourable in 29 cases, with one fatality due to metastatic melanoma. CONCLUSIONS:In a population-based setting, most conjunctival tumours are benign, and the majority of lesions are melanocytic. While it is important to remain vigilant for malignancies, most conjunctival lesions in a community-based practice are not life-threatening.

SUBMITTER: Dalvin LA

PROVIDER: S-EPMC6422677 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Population-based incidence of conjunctival tumours in Olmsted County, Minnesota.

Dalvin Lauren A LA Salomão Diva R DR Patel Sanjay V SV

The British journal of ophthalmology 20180306 12

<h4>Aim</h4>To determine population-based incidence of conjunctival tumours in Olmsted County, Minnesota.<h4>Methods</h4>The Rochester Epidemiology Project medical record linkage system was used to identify patients with conjunctival tumours in Olmsted County (1 January 1980 to 31 December 2015). Records were reviewed for demographics, types of tumours, histopathology, treatment and clinical course. Incidence rate of all tumours was calculated per 1 000 000 person-years. Poisson regression analy ...[more]

PMID: 29511061

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Project description:BackgroundAdrenal tumours are commonly encountered in clinical practice, but epidemiological data mainly originate from referral centres. We aimed to determine incidence, prevalence, and rates of malignancy and hormone excess in patients with adrenal tumours in a standardised geographically well defined population.MethodsIn this retrospective population-based cohort study we assessed the standardised incidence rate of adrenal tumours in all patients with tumours who lived in Olmsted County, MN, USA, from Jan 1, 1995, to Dec 31, 2017. The Rochester Epidemiology Project infrastructure, which links medical records across all health-care providers for the entire population of Olmsted County since 1966, was used to allow researchers to identify individuals with specific diagnoses, surgical interventions, and other procedures, and to locate their medical records, which were then used in the analysis. Incidence rates and prevalence were standardised for age and sex according to the 2010 US Population.FindingsAn adrenal tumour was diagnosed in 1287 patients (median age 62 years; 713 (55·4%) were women; and 13 (1·0%) were children). Standardised incidence rates increased from 4·4 (95% CI 0·3-8·6) per 100 000 person-years in 1995 to 47·8 (36·9-58·7) in 2017, mainly because of the incidental discovery of adenomas less than 40 mm in diameter in patients older than 40 years. Prevalence of adrenal tumours in 2017 was 532 per 100 000 inhabitants, ranging from 13 per 100 000 in children (aged <18 years) to 1900 per 100 000 in patients older than 65 years. 111 (8·6%) of 1287 patients were diagnosed with malignancy (96 [7·5%] of whom has metastases), 14 (1·1%) with phaeochromocytoma, and 53 (4·1%) with overt steroid hormone excess. Malignancy was more common in children (62%) versus those older than 18 years (8%; p<0·0001), tumours discovered during cancer-staging or follow-up (43% vs 3% for incidentalomas; p<0·0001), tumours more than 40 mm in diameter (34% vs 6% for tumours <20 mm; p<0·0001), tumours with unenhanced CT attenuation of 30 Hounsfield units or more (20% vs 1% for <20 Hounsfield units; p<·0001), and bilateral masses (16% vs 7% for unilateral, p=0·0004).InterpretationAdrenal tumour standardised incidence rates increased 10 times from 1995 to 2017. Population-based data revealed lower rates of malignancy, phaeochromocytoma, and overt steroid hormone excess than previously reported.FundingNational Institutes of Health.

Dataset Information

Population-based incidence of conjunctival tumours in Olmsted County, Minnesota.

Publications

Population-based incidence of conjunctival tumours in Olmsted County, Minnesota.

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