NIH State-of-the-Science Panel To Evaluate Treatment Strategies for Clinically Inapparent Adrenal Gland Masses

Kelli Marciel, NIH Office of Medical, Applications of ResearchBob Bock, National Institute of Child Health

The National Institutes of Health (NIH) Consensus Development Program will hold a State-of-the-Science Conference on Management of the Clinically Inapparent Adrenal Mass (Incidentaloma) on February 4-6, 2002, in the main auditorium of the William H. Natcher Building on the NIH campus in Bethesda, Maryland. A news conference will conclude the 2-day meeting at 1:00 p.m. ET on Wednesday, February 6, 2002.

The adrenals are triangular glands that sit atop each kidney. They influence or regulate the body's metabolism, salt and water balance, response to stress, and other important functions by secreting a variety of hormones. Adrenal gland masses are among the most common tumors in humans, occuring in at least 3 percent of persons over age 50. Although most cause no symptoms or health problems, a small proportion can lead to serious diseases, and approximately one out of every 4,000 adrenal masses is cancerous. Physicians discover many adrenal masses inadvertently, while testing or treating patients for other conditions. These clinically inapparent masses are commonly known as incidentalomas.

Incidentalomas raise challenging questions for physicians and their patients, including what, if any, surgical or non-surgical treatment is the best approach. The appropriate management of incidentalomas promises to be an increasingly common challenge for our aging society.

Over the past several years, new information about the epidemiology, biology, screening, treatment, and followup of adrenal tumors has become available. This conference will explore and assess the current scientific knowledge regarding adrenal incidentalomas. Specifically, the conference will address the following key questions:

What are the causes, prevalence and natural history of clinically inapparent adrenal masses?Based on available scientific evidence, what is the appropriate evaluation of a clinically inapparent adrenal mass?What criteria should guide the decision on surgical versus nonsurgical management of these masses?If surgery is indicated, what is the appropriate procedure?What is the appropriate follow up for patients for each management approach?What additional research is needed to guide practice?

During the first day-and-a-half of the conference, experts will present the latest adrenal mass research findings to an independent, non-Federal panel. After weighing all of the scientific evidence, the panel will draft a statement, addressing the key questions listed above.

An evidence report on this topic, prepared by the New England Medical Center Evidence-based Practice Center (NEMC EPC), under contract to the Agency for Healthcare Research and Quality (AHRQ), will be among the evidence considered by the panel. EPC evidence reports are comprehensive systematic reviews and analyses of published scientific evidence. The Management of the Clinically Inapparent Adrenal Mass (Incidentaloma) evidence report will be available on February 6, 2002, the final day of the conference, at http://www.ahrq.gov/clinic/epcix.htm.

The panel will present its draft statement to the public for comment at 9:00 a.m. on Wednesday, February 6. Following this public comment session, the panel will release its revised statement at a news conference at 1:00 p.m. and take questions from the media.

The state-of-the-science statement is the report of an independent panel and is not a policy statement of the NIH or the Federal Government. The NIH Consensus Development Program was established in 1977 to resolve in an unbiased manner controversial topics in medicine. To date, NIH has conducted 115 consensus development conferences and 20 state-of-the-science conferences addressing a wide range of controversial medical issues important to health care providers, patients, and the general public.

The primary sponsors of this meeting are the National Institute of Child Health and Human Development and the NIH Office of Medical Applications of Research.

Additional information about this conference, including the meeting agenda, local area hotels, and directions to NIH, is available at the NIH Consensus Development Program Web site at http://consensus.nih.gov.

Note to TV Editors: The news conference at 1 p.m. on Wednesday, February 6, 2002 will be broadcast live via satellite on the following coordinates:

Galaxy 3 Transponder 7Downlink Frequency: 3840 HorizontalPolarity: 95 degrees WAudio: 36 mhzTest time: 12:30 - 1:00 p.m.

Note to Radio Editors: An audio report of the conference results will be available after 4 p.m. February 6, 2002 from the NIH Radio News Service by calling 1-800-MED-DIAL (1-800-633-3425).

NIH Videocasting will broadcast the conference live on the Internet. Go to the NIH Videocast Web site �� http://videocast.nih.gov/ �� any day during the conference and look for the link to the conference under "Today's Events."

If you require any assistance or assistive devices to participate in this conference, please contact Prospect Associates at (301) 592-3320, or via e-mail at adrenalmass@prospectassoc.com, at least 48 hours before the conference.

The Office of the Director is a component of the National Institutes of Health, U.S. Department of Health and Human Services.