Loading Curie Briefs...
Getting the latest healthcare news for you
Getting the latest healthcare news for you
A single cortisol test might be leaving adrenal incidentaloma patients misclassified. A large new study found that about 1 in 5 patients with these benign adrenal masses changed cortisol status over time — and those with persistently elevated levels faced a significantly higher risk of worsening hypertension. Researchers say repeat testing may be warranted in select cases, especially before surgery.
A single baseline cortisol test may not tell the full story for patients with adrenal incidentalomas — benign adrenal masses found incidentally in 3%–7% of adults. A major new study published in The Lancet Diabetes & Endocrinology found that 22.3% of patients changed their cortisol classification over time, with most shifts occurring within the first three years of follow-up. That means a snapshot approach could be misclassifying a meaningful number of patients.
The retrospective study tracked 2,525 patients across 25 centers in 14 countries over a median of 80 months. Patients with persistently abnormal dexamethasone suppression test (DST) results had a 34% higher risk of worsening hypertension compared to those with normal results — a clinically significant finding given that current guidelines don't recommend routine repeat testing.
By the Numbers:
Why it matters: Experts say repeat testing should be individualized — most useful for patients with borderline results or when the outcome would change management, like surgical eligibility. Prospective trials are still needed to confirm whether retesting actually improves patient outcomes.
