Population-Based vs Health System and Insurer Records: Significant Underdiagnosis of PCOS.
Level 3 - non-randomized controlled study
Systematic review of observational prevalence and administrative database studies
PubMed 39833660 · doi:10.1210/clinem/dgaf037
What was done
Authors searched PubMed and Embase through July 2023 for studies comparing polycystic ovary syndrome (PCOS) prevalence in the general population versus Health System or Insurer Records (HSIR). The review analyzed 7 population-based studies and 11 HSIR-based studies covering populations in 3 countries.
What was found
In the United States, population-based studies reported a PCOS prevalence of 4% to 19.6%, whereas HSIR-based studies reported 0.2% to 5.2%. In the United Kingdom, an HSIR-based study reported a PCOS prevalence of 1.34%, compared to approximately 8% in the population. In South Korea, population-based studies reported prevalence rates of 4.9% and 7%, compared to 0.12% to 0.33% in one HSIR and 4.3% in another. Although PCOS detection in HSIR improved over time where data were available, it remained below population estimates.
Why it matters
These findings show a substantial gap between true population prevalence and diagnostic coding in clinical databases, confirming widespread underdiagnosis and underreporting of a major cardiometabolic condition in routine care.
Limits
Data were available from only 3 countries (United States, United Kingdom, and South Korea). The abstract does not provide total participant numbers, pooled effect estimates, or details on diagnostic criteria and coding variations across systems.
Cited by
- supports Studies show that 70% of PCOS patients are never diagnosed.