Global epidemiology of acromegaly: A systematic review and meta-analysis

Objective: To date, no systematic reviews and meta-analysis on the global epidemiology of acromegaly are available in the literature. The aims of this study are to provide a systema tic review and a meta-analysis of the global epidemiology of acromegaly and to evaluate the quality of study reporting fo r the identified studies. Methods: MEDLINE, EMBASE and The Cochrane Library databases were search ed for studies assessing the epidemiology of acromegaly from inception until 31 January 2020 . We included original observational studies written in English, reporting acromegaly prevalence and/or incidence fo r a well-defined geographic area. Two reviewers independently extracted data and performed quality assessments. Prevalence and incidence pooled estimates were derived by performing a random-effects meta-analysis. Results: A total of 32 studies were included in the systematic review, and 22 of them were included in the meta-analysis. The pooled prevalence of acromegaly was 5.9 (95% CI: 4.4-7.9) per 100 000 persons, while the incidence rate (IR) was 0.38 (95% CI: 0.32-0.44) cases per 100 000 person-year s. For both prevalence and IR, considerable between-study heterogeneity was found (I2 = 99.3 and 86.0%, respectively). The quality of study reporting was rated as the medium for 20 studies and low for 12 studies. Conclusions: Although the largest amount of heterogeneity was due to the hi gh precision of the studies' estimates, data source and geographic area could represent relevant study-level factors which could explain about 50% of the total between-study variability. Large-scale high-quality studies on the epidemiology of acromegaly are warranted to help the public health system in making decisions.