Abstract 239P
Background
Multiple Endocrine Neoplasia Type 1 (MEN1) is an inherited syndrome characterised by the occurrence of two or more tumours including: primary hyperparathyroidism (PHPT), pancreatic neuroendocrine tumours (PNETs) and pituitary adenomas (PAs). Accurate biochemical and radiological screening for these tumours is pivotal in their early detection and management. We aim to evaluate the adherence to screening protocols at the Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM) with published clinical MEN1 guidelines.
Methods
Medical records were reviewed for patients with MEN1 who attended OCDEM between January 2019 and January 2024. Key metrics assessed included adherence to recommended screening intervals set in the current clinical practice guidelines for MEN1 for the three main tumour types (PHPT, PNETs and PAs). Total adherence was defined as patients undergoing all screening recommendations for all tumour types, calculated by averaging the number of studies over the number of years. Harm related to nonadherence was defined as new metastatic disease, or disease requiring urgent treatment (i.e. clinical decision making changed due to the results of the screening).
Results
38 MEN1 patients were included: mean age of 46 years (range 18 – 78 years), 57.9% (22/38) were male and 42.1% (16/38) were female. All patients had PNETs, 97.4% (37/38) had PHPT, and 50% had PAs. Full compliance with radiological and biochemical screening was seen in 15.7% (6/38) and 2.6% (1/38) of patients, respectively. For tumour subtype, adherence to recommended imaging was 84.2% (32/38) for abdomen (PNETs) and 78.9% (30/38) for pituitary (PAs). For biochemical testing, adherence was 76.3% (29/38) for calcium studies (PHPT) and 36.8% (14/38) for gut hormones. For patients non-compliant with follow-up imaging and biochemistry, no patient harm was identified. New metastatic spread occurred in 18.4% (7/38) of patients, none being nonadherent to abdominal scans.
Conclusions
At our centre, the compliance for both biochemical and radiological screening for tumours seen in MEN1 was low; this however did not appear to cause patient harm. These findings raise the prospect of revisiting and potentially refining the screening protocol.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.