In a recent publication in the American Journal of Obstetrics and Gynecology, researchers conducted a population-based U.S. study to approximate the incidence, prevalence, and trends of polycystic ovary syndrome (PCOS) based on age, race, and ethnicity and diagnosing healthcare provider type.
The researchers wrote, “Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age, yet U.S. incidence estimates do not exist, and prevalence estimates vary widely.”
In this retrospective study, researchers evaluated healthcare data from 177,527 women aged 16 to 40 years, with an average age of 26.9 years and an average BMI of 31.6 kg/m2, who were enrolled in Kaiser Permanente Washington for at least 3 years between 2006 and 2019 with at least one healthcare encounter during this time. PCOS prevalence cases were defined as women with a PCOS diagnosis at any time before the end of 2019. Individuals with PCOS diagnoses before study entry were omitted from incidence rate estimations. The incidence rates were adjusted by age using direct standardization to the 2010 U.S. census data.
The results revealed that among 177,527 eligible patients who contributed 586,470 person-years, 2,491 incident PCOS cases were documented. The prevalence among patients aged 16 to 40 years was 5.2% across all race and ethnicity groups, with incidence rates reported as 6.8% among Hispanics, 5.2% among Caucasians, 4.0% among Asians, 6.9% among Native Americans, 4.6% among African Americans, and 7.6% among Hawaiian and Pacific Islanders. The prevalence documented as the highest among the Hawaiian and Pacific Islander group, followed by Native American and Hispanic groups.
Additionally, medical record review classified 60% as definite or probable incident, 14% as possible incident, and 17% as prevalent PCOS. The overall positive predictive value of the PCOS International Classification of Diseases diagnosis code for identifying definite, probable, or possible incident PCOS was 76%.
Based on their findings, the authors wrote, “Among a cohort of non-selected females in the United States, we observed stable rates of incident polycystic ovary syndrome diagnoses over time. The incidence of polycystic ovary syndrome was 4- to 5-fold greater than reported for the United Kingdom. The prevalence of polycystic ovary syndrome (5.2%) was almost double before the published U.S. estimates (2.9%) based on the International Classification of Diseases codes.”
They also indicated that the incidence of PCOS expanded over time in younger individuals and that the average age of diagnosis was higher (27 years) than in previously described preselected cohorts.
Additionally, their findings indicated that race and ethnicity and provider type did not appear to have a key impact on temporal rates and that incident diagnoses augmented over time in younger patients and diminished in older age groups. This possibly correlated with changing practice patterns, with greater cognizance among practitioners of the impact of PCOS on long-term health outcomes and enhanced measures to identify and prevent PCOS. They also noted that the ongoing obesity epidemic may be a contributing factor that may account for the growing incidence of PCOS at earlier ages.
The authors concluded, “Increased acceptance of the diagnosis of PCOS among adolescents and young patients may, in part, explain the rising incidence among younger individuals. These findings should guide healthcare systems to direct adequate and proportional resources to this common, but complex, gynecologic condition, with a long-term goal to diminish or prevent PCOS-associated comorbid conditions through early diagnosis and treatment.”
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Published May 17, 2023