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Review
. 2024 Jul;115(1):1-13.
doi: 10.1007/s00223-024-01219-y. Epub 2024 May 21.

Risk of Malignant Neoplasm in Patients with Primary Hyperparathyroidism: A Systematic Review and Meta-analysis

Nipith Charoenngam  1   2 , Thanitsara Rittiphairoj  3   4 , Chalothorn Wannaphut  5 , Watsachon Pangkanon  6 , Sakditat Saowapa  6
Affiliations
Review

Risk of Malignant Neoplasm in Patients with Primary Hyperparathyroidism: A Systematic Review and Meta-analysis

Nipith Charoenngam et al. Calcif Tissue Int. 2024 Jul.

Abstract

This study aimed to evaluate the prevalence and risk of malignant neoplasm in primary hyperparathyroidism (PHPT) patients. Potentially eligible studies were retrieved from PubMed and Embase databases from inception to November 2023 using search strategy consisting of terms for "Primary hyperparathyroidism" and "Malignant neoplasm". Eligible study must report prevalence of malignant neoplasm among patients with PHPT or compare the risk of malignant neoplasm between patients with PHPT and comparators. Point estimates with standard errors were extracted from each study and combined using the generic inverse variance method.A total of 11,926 articles were identified. After two rounds of systematic review, 50 studies were included. The meta-analysis revealed that pooled prevalence rates of overall cancer was 0.19 (95%CI: 0.13-0.25; I2 94%). The two most prevalent types of malignancy among patients with PHPT ware papillary thyroid cancer (pooled prevalence: 0.07; 95%CI: 0.06-0.08; I2 85%) and breast cancer (pooled prevalence: 0.05; 95%CI: 0.03-0.07; I2 87%). Subgroup analysis of studies focusing on patients undergoing parathyroidectomy reported a fourfold higher prevalence of papillary thyroid cancer than the remaining studies (0.08 versus 0.02). The meta-analysis of cohort studies found a significant association between PHPT and overall cancer with the pooled risk ratio of 1.28 (95%CI: 1.23-1.33; I2 66.9%).We found that the pooled prevalence of malignant neoplasm in PHPT was 19%, with papillary thyroid cancer and breast cancer being the most prevalent types. The meta-analysis of cohort studies showed that patient with PHPT carried an approximately 28% increased risk of malignancy.

Keywords: Breast cancer; Malignant neoplasm; Meta-analysis; Primary hyperparathyroidism; Systematic review; Thyroid cancer.

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Conflict of interest statement

Nipith Charoenngam, Thanitsara Rittiphairoj, Chalothorn Wannaphut, Watsachon Pangkanon, Sakditat Saowapa declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Study identification and literature review process
Fig. 2
Fig. 2
Forest plot of the meta-analysis of risk of overall cancer in patients with primary hyperparathyroidism versus comparators
See this image and copyright information in PMC

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