Skip to main content
Log in

Incidence of Cushing’s syndrome and Cushing’s disease in commercially-insured patients <65 years old in the United States

  • Published:
Pituitary Aims and scope Submit manuscript



To estimate the incidence of Cushing’s syndrome (CS) and Cushing’s disease (CD) in the US.


MarketScan Commercial database 2007–2010 (age <65 years) was used. CS patients were defined with ≥2 claims of CS diagnosis, while CD patients were defined with CS plus a benign pituitary adenoma diagnosis or hypophysectomy in the same calendar year. Annual incidence was calculated by dividing the number of CS or CD cases by the total number of members with the same enrollment requirement during the calendar years.


CS incidence rates per million person-years were 48.6 in 2009 and 39.5 in 2010. The lowest rates of CS were in ≤17-year-olds and highest rates were in 35 to 44-year-olds. CD incidence rates were 7.6 in 2009 and 6.2 in 2010. The lowest rates of CD were in ≤17-year-olds and highest rates were in 18 to 24-year-olds. The rates varied by sex (2.3–2.7 in males, 9.8–12.1 in females). In females, lowest rates ranged 2.5–4.0 in ≤17-year-olds and highest 16.7–27.2 in 18–24 year olds. In males, there were too few cases to report estimates by age.


In the first large US-based study, the annual incidence of CS in individuals <65 years old was nearly 49 cases per million, substantially higher than previous estimates, which were based primarily on European data. Using similar methods, we estimated the incidence of CD at nearly 8 cases per million US population. These estimates, if confirmed in other epidemiologic databases, represent a new data reference in these rare conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others


  1. Newell-Price J, Bertagna X, Grossman AB, Nieman LK (2006) Cushing’s syndrome. Lancet 367(9522):1605–1617

    Article  CAS  PubMed  Google Scholar 

  2. Nieman LK, Biller BMK, Findling JW, Newell-Price J, Savage MO, Stewart PM, Montori VM (2008) The diagnosis of Cushing’s syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 93:1526–1540

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Colao A, Boscaro M, Ferone D, Casanueva FF (2014) Managing Cushing’s disease: the state of the art. Endocrine. doi:10.1007/s12020-013-0129-2

  4. Arnaldi G, Angeli A, Atkinson AB, Bertagna X, Cavagnini F, Chrousos GP, Fava GA, Findling JW, Gaillard RC, Grossman AB, Kola B, Lacroix A, Mancini T, Mantero F, Newell-Price J, Nieman LK, Sonino N, Vance ML, Giustina A, Boscaro M (2003) Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab 88(12):5593–5602

    Article  CAS  PubMed  Google Scholar 

  5. Biller BMK, Grossman AB, Stewart PM, Melmed S, Bertagna X, Bertherat J, Buchfelder M, Colao A, Hermus AR, Hofland LJ, Klibanski A, Lacroix A, Lindsay JR, Newell-Price J, Nieman LK, Petersenn S, Sonino N, Stalla GK, Swearingen B, Vance ML, Wass JA, Boscaro M (2008) Treatment of adrenocorticotropin-dependent Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab 93(7):2454–2462

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Arnardóttir S, Sigurjonsdóttir HA (2011) The incidence and prevalence of Cushing’s disease may be higher than previously thought: results from a retrospective study in Iceland 1955 through 2009. Clin Endocrinol 74(6):792–793

    Article  Google Scholar 

  7. Etxabe J, Vazquez JA (1994) Morbidity and mortality in Cushing’s disease: an epidemiological approach. Clin Endocrinol 40:479–484

    Article  CAS  Google Scholar 

  8. Lindholm J, Juul S, Jørgensen JO, Astrup J, Bjerre P, Feldt-Rasmussen U, Hagen C, Jørgensen J, Kosteljanetz M, Kristensen L, Laurberg P, Schmidt K, Weeke J (2001) Incidence and late prognosis of Cushing’s syndrome: a population-based study. J Clin Endocrinol Metab 86(1):117–123

    CAS  PubMed  Google Scholar 

  9. Steffensen C, Bak AM, Rubeck KZ, Jørgensen JO (2010) Epidemiology of Cushing’s syndrome. Neuroendocrinology 92(Suppl 1):1–5

    Article  CAS  PubMed  Google Scholar 

  10. Guaraldi F, Salvatori R (2012) Cushing syndrome: maybe not so uncommon of an endocrine disease. J. Am. Board Fam. Med. 25(2):199–208

    Article  PubMed  Google Scholar 

  11. Newell-Price J, Grossman AB (2007) Differential diagnosis of Cushing’s syndrome. Arq. Bras. Endocrinol. Metabol. 51(8):1199–1206

    Article  PubMed  Google Scholar 

  12. Swearingen B, Wu N, Chen SY, Pulgar S, Biller BM (2011) Health care resource use and costs among patients with Cushing disease. Endocr. Pract. 17(5):681–690

    Article  PubMed  Google Scholar 

  13. Abbas S, Ihle P, Köster I, Schubert I (2012) Estimation of disease incidence in claims data dependent on the length of follow-up: a methodological approach. Health Serv Res 47(2):746–755

    Article  PubMed Central  PubMed  Google Scholar 

  14. Rodríguez-Ezpeleta N, Alvarez-Busto J, Imaz L, Regueiro M, Azcárate MN, Bilbao R, Iriondo M, Gil A, Estonba A, Aransay AM (2010) High-density SNP genotyping detects homogeneity of Spanish and French Basques, and confirms their genomic distinctiveness from other European populations. Hum Genet 128(1):113–117

    Article  PubMed  Google Scholar 

  15. Catargi B, Rigalleau V, Poussin A, Ronci-Chaix N, Bex V, Vergnot V, Gin H, Roger P, Tabarin A (2003) Occult Cushing’s syndrome in type-2 diabetes. J Clin Endocrinol Metab 88(12):5808–5813

    Article  CAS  PubMed  Google Scholar 

  16. Contreras LN, Cardoso E, Lozano MP, Pozzo J, Pagano P, Claus-Hermbeg H (2000) Detection of preclinical Cushing’s syndrome in overweight type 2 diabetic patients. Medicina (B Aires). 60(3):326–330

    CAS  PubMed  Google Scholar 

  17. Leibowitz G, Tsur A, Chayen SD, Salameh M, Raz I, Cerasi E, Gross DJ (1996) Pre-clinical Cushing’s syndrome: an unexpected frequent cause of poor glycaemic control in obese diabetic patients. Clin Endocrinol 44(6):717–722

    Article  CAS  Google Scholar 

  18. Tyree PT, Lind BK, Lafferty WE (2006) Challenges of using medical insurance claims data for utilization analysis. Am J Med Qual 21(4):269–275

    Article  PubMed Central  PubMed  Google Scholar 

Download references


Funding for this study was provided by Novartis Pharmaceuticals Corporation. The authors thank Dr. Gordon H. Sun for critical review of the manuscript.

Conflict of interest

This study was funded by Novartis Pharmaceuticals Corporation. Maureen P. Neary and William H. Ludlam are employees of Novartis Pharmaceuticals Corporation; Michael S. Broder, Eunice Chang, and Dasha Cherepanov are employees of Partnership for Health Analytic Research, LLC, a health services research company paid by Novartis to conduct this research.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dasha Cherepanov.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Broder, M.S., Neary, M.P., Chang, E. et al. Incidence of Cushing’s syndrome and Cushing’s disease in commercially-insured patients <65 years old in the United States. Pituitary 18, 283–289 (2015).

Download citation

  • Published:

  • Issue Date:

  • DOI: