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Cited by 57Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsNeuroendocrine Tumor Research Advances

Pros and cons of screening for occult Cushing syndrome

Tabarin, Antoine, Perez, Paul·2011·Nature Reviews Endocrinology
DOI 10.1038/nrendo.2011.51
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Abstract

Systematic screening studies performed mainly in patients with diabetes mellitus have revealed an unexpectedly high prevalence of occult Cushing syndrome. Such studies may provide a rationale for systematically screening obese patients with type 2 diabetes mellitus. However, a screening strategy is only justified if it is supported by enough evidence of its efficacy and if the benefits will outweigh drawbacks. To date, the natural history of occult Cushing syndrome and its possible effect on long-term morbidity are unknown. The clinical spectrum of occult Cushing syndrome and its relatively low prevalence may potentially negatively affect the performance of endocrine tests used to diagnose overt Cushing syndrome and generate false positives. Whether the cure of occult Cushing syndrome favorably influences clinical outcomes and is more beneficial than treatment of diabetes mellitus and cardiovascular risk factors with currently available pharmacological tools remains to be demonstrated. Last, the acceptability of a screening program by professionals and the health-care system in terms of workload and costs is highly questionable. Thus, an assessment of the indications for and against screening for occult Cushing syndrome on the basis of currently available data suggests that, to date, the cons surpass the pros.

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Crossref · 10.1038/nrendo.2011.51

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  • The frequency of Cushing syndrome in an unselected type 2 diabetes population was too low compared with false-positive results to make routine screening applicable, given high cost-effectiveness and lack of specific tests.

    “On the other hand, the frequency of CS identified in an unselected population of type  DM patients was too low compared with the number of false-positive results to make a routine screening strategy applicable in practice (), given its high cost-effectiveness and the lack of specific tests for diagnosing CS, especially in patients with a slightly elevated cortisol secretion and SCS ().”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [260]

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Authors
Tabarin, A., & Perez, P.
Affiliations
  • Université de Bordeaux (FR)
  • Inserm (FR)
Corresponding author
Tabarin, Antoine
ORCID
Tabarin, Antoine
Venue
Nature Reviews Endocrinology
Publisher
Springer Science and Business Media LLC
Published
2011-03-22
Volume
7
Issue
8
Pages
445-455
ISSN
  • 1759-5029 (ISSN-L)
  • 1759-5037
DOI
10.1038/nrendo.2011.51
OpenAlex
W1985709375
Cited by
57
References
113
Citations by year
2026: 1 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 4 · 2013: 4 · 2012: 10
FWCI
0.89
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Nature Reviews Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
Keywords
screening, type 2 diabetes, obesity, prevalence, natural history (disease), false positives, cardiovascular risk, screening costs, screening acceptability, benefits and harms
MeSH terms
Cushing Syndrome, Diabetes Mellitus, Humans, Mass Screening, Obesity

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