The impact of pituitary adenoma on morbidity. Increased sick leave and disability retirement in a cross-sectional analysis of Swedish national data.

Abstract

To quantify sick leave and medical retirement for the year 1989 in adults with a history of nonsecreting pituitary adenoma. A cross-sectional analysis of official Swedish data from 1989 was performed. Sick leave and disability pension data for these patients were obtained from the Swedish National Social Insurance Board, which also supplied information on sick leave taken by an age- and gender-matched control population of 5121 individuals. Uptake of disability pensions and the reasons for drawing these pensions in the study group were compared with national statistics. A group of 809 eligible adults with nonsecreting pituitary adenoma was identified from the national cancer registry. Almost a quarter of the patients with a history of pituitary adenoma had retired due to ill health (23.8%); this was twice the figure expected from national statistics (11.5%). Similar results were obtained when men and women were considered separately. Some patients (17%) had received disability pensions before the diagnosis of pituitary adenoma, but the majority (75%) retired on medical grounds at least 1 year after their diagnosis. The reasons for early retirement in the study group were largely related to the diagnosis of pituitary adenoma (e.g. neoplasm, endocrine disorders), but there was some evidence of an increase in the number of disability pensions awarded because of diseases of the nervous system and sensory organs. Patients with a history of pituitary adenoma took significantly more sick leave in 1989 than those in the control group (mean 40.2 vs 24.0 days), and this significant difference applied to both sexes. A cross-sectional analysis of Swedish national data from 1989 showed excess morbidity, relative to reference data, in patients with a history of nonsecreting pituitary adenoma. Suboptimal conventional hormone replacement therapy and untreated growth hormone deficiency might to some extent explain the increased morbidity found in the present study.