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Marked Increase in Incident Gynecomastia: A 20-Year National Registry Study, 1998 to 2017

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Trine Koch, Elvira V Bräuner, Alexander S Busch, Martha Hickey, Anders Juul

The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 10, October 2020, Pages 3134–3140, https://doi.org/10.1210/clinem/dgaa440   Published: 07 July 2020

Context

Gynecomastia, the proliferation of mammary glandular tissue in the male, is a frequent but little-studied condition. Available prevalence data are based on selected patient populations or autopsy cases with their inherent bias.

Objective

The objective of this work is to evaluate the age-related incidence and secular trends in gynecomastia in the general population.

Design

An observational, 20-year national registry study was conducted.

Setting

This population-based study used nationwide registry data.

Participants

Participants included all Danish males (age 0-80 years) with a first-time diagnosis of gynecomastia.

Main Outcome Measures

All Danish males (age 0-80 years) were followed up for incident diagnosis of gynecomastia in the Danish National Patient Registry from 1998 to 2017 using the International Codes of Diseases, 10th revision, and the Danish Health Care Classification System. Age-specific incidence rates were estimated. The hypothesis tested in this study was formulated prior to data collection.

Results

Overall, a total 17 601 males (age 0-80 years) were registered with an incident diagnosis of gynecomastia within the 20-year study period, corresponding to 880 new cases per year and an average 20-year incidence of 3.4 per 10 000 men (age 0-80 years). The average annual incidence was 6.5/10 000 in postpubertal males age 16 to 20 years and 4.6/10 000 in males age 61 to 80 years, with a respective 5- and 11-fold overall increase in these 2 age groups over the 20-year period.

Conclusions

The incidence of gynecomastia has dramatically increased over the last 20 years, implying that the endogenous or exogenous sex-steroid environment has changed, which is associated with other adverse health consequences in men such as an increased risk of prostate cancer, metabolic syndrome, type 2 diabetes, or cardiovascular disorders.

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