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Serum calcium should be measured in patients with suggestive symptoms, reduced bone mineral density or minimal trauma fractures, and in those with renal stones. Other indications are detailed in the manuscript. In patients with hypercalcaemia, intact parathyroid hormone, 25\u2010hydroxy vitamin D, phosphate, and renal function should be measured. In established PHPT, assessment of bone mineral density, vertebral fractures, urinary tract calculi\/nephrocalcinosis and quantification of urinary calcium excretion is warranted. Parathyroidectomy is the only definitive treatment and is warranted for all symptomatic patients and should be considered for asymptomatic patients without contraindications to surgery and with &gt;10 years life expectancy. In patients who do not undergo surgery, we recommend annual evaluation for disease progression. Where the diagnosis is not clear or the risk\u2010benefit ratio is not obvious, multidisciplinary discussion and formulation of a consensus management plan is appropriate. Genetic testing for familial hyperparathyroidism is recommended in selected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These clinical consensus recommendations were developed to provide clinicians with contemporary guidance on the assessment and management of PHPT in adults. It is anticipated that improved health outcomes for individuals and the population will be achieved at a decreased cost to the community.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14659","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T10:59:08Z","timestamp":1640084348000},"page":"3-18","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Primary hyperparathyroidism in adults\u2014(Part I) assessment and medical management: Position statement of the endocrine society of Australia, the Australian &amp; New Zealand endocrine surgeons, and the Australian &amp; New Zealand bone and mineral society"],"prefix":"10.1111","volume":"100","author":[{"given":"Frances","family":"Milat","sequence":"first","affiliation":[{"name":"Department of Endocrinology Monash Health Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research Victoria Australia"},{"name":"Department of Medicine Nursing &amp; Health Sciences, Monash University Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabashini K.","family":"Ramchand","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Austin Health Victoria Australia"},{"name":"Department of Medicine Austin Health, University of Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2776-2083","authenticated-orcid":false,"given":"Madhuni","family":"Herath","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research Victoria Australia"},{"name":"Department of Medicine Nursing &amp; Health Sciences, Monash University Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Gundara","sequence":"additional","affiliation":[{"name":"Department of Surgery Redland Hospital, Metro South and Faculty of Medicine, University of Queensland  Australia"},{"name":"Department of Surgery Logan Hospital, Metro South and School of Medicine and Dentistry Griffith University Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of General Surgery Wellington Regional Hospital Wellington New Zealand"},{"name":"Department of Surgery University of Otago Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Surgery St Vincent's Hospital Victoria Australia"},{"name":"Department of Surgery Austin Hospital Victoria Australia"},{"name":"Department of Surgery Royal Children's Hospital Victoria Australia"},{"name":"Department of Surgery University of Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian M.","family":"Girgis","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Westmead Hospital New South Wales Australia"},{"name":"Department of Endocrinology Royal North Shore Hospital, St Leonards, New South Wales  Australia"},{"name":"Faculty of Medicine and Health University of Sydney  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1545-0368","authenticated-orcid":false,"given":"Roderick","family":"Clifton\u2010Bligh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Royal North Shore Hospital, St Leonards, New South Wales  Australia"},{"name":"Faculty of Medicine and Health University of Sydney  New South Wales Australia"},{"name":"Kolling Institute University of Sydney  New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans G.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Unit, Alfred Pathology Service Alfred Health Victoria Australia"},{"name":"Department of Endocrinology Alfred Hospital Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita M. 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