https://orcid.org/0000-0002-7536-8497
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Alexander A Leung, Janice L Pasieka, Hossein Sadrzadeh, Gregory A Kline, Pheochromocytoma and paraganglioma: time and space are only part of the essence, European Journal of Endocrinology, Volume 186, Issue 1, Jan 2022, Pages L3–L4, https://doi.org/10.1530/EJE-21-1080
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We thank Dr Ebbehøjfor and colleagues (1) for their enthusiasm for our recent epidemiological study on the incidence of pheochromocytoma and paraganglioma (PPGL) in Alberta, Canada (2), along with their interest in our follow-up analysis showing an increased annual incidence of disease with higher altitude from selected studies (3). In their letter, they conducted an updated search of the literature, analyzed the available data according to annual incidence at the time of observation, and demonstrated that the frequency of detected PPGL has also increased over time.
The findings presented by Dr Ebbehøjfor and colleagues are important contributions that help to advance our understanding of the epidemiology of PPGL. We point out that their interpretation of the data is not fundamentally different than our own. We previously stated that although variations in altitude account for a small degree of the between-study differences observed (a finding that they also corroborate), other factors such as variable disease detection methods, data sources, and study quality are likely more important sources of statistical heterogeneity (2, 3). We also acknowledged the apparent rise in PPGL frequency with more recent data and further postulated that it was mediated, at least in part, through similar mechanisms (i.e. increased global awareness of these tumors with improvements in diagnostic practices over time) (2), as others have likewise suggested (4).
