{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:50:31Z","timestamp":1789426231343,"version":"build-2803163510"},"reference-count":30,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Early genetic association studies yielded too high risk estimates for multiple endocrine neoplasia (MEN2A), suggesting a need for extended surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective was to delineate temporal changes in MEN2A presentation by birth cohort analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Birth cohort analyses (10-year increments; \u22641950 to 2011-2020) of carriers of rearranged during transfection (RET) mutations who underwent surgery for MEN2A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Included in this study were 604 carriers (155 index, 445 nonindex, 4 additional patients), with 237 carriers harboring high-risk mutations, 165 carriers moderate\u2013high risk mutations, and 202 carriers low\u2013moderate risk mutations. With increasing recency of birth cohorts, there was a continual decline in index patients from 41-74% to 0% (P &amp;lt; .001) and of medullary thyroid cancer (MTC) from 96-100% to 0-33% (P &amp;lt; .001). Node metastases diminished from 62-70% to 0% (P \u2264 .001; high and low\u2013moderate risk mutations), whereas biochemical cure after thyroidectomy surged from 17-33% to 100% (P \u2264 .019; high and low\u2013moderate mutations). Surgical interventions for MEN2A-related tumors were performed increasingly earlier, causing median carrier age to fall: from 51-63 to 3-5 years at thyroidectomy (P &amp;lt; .001); from 46-51 to 24-25 years at first adrenalectomy (P \u2264 .013; high and moderate\u2013high risk mutations); and from 43.5-66 to 16.5-32 years at parathyroidectomy. MTC diameters were more effectively decreased from 14-32 to 1-4 mm (P \u2264 002) than pheochromocytoma diameters (nonsignificant).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These insights into MEN2A presentation, adjusted by birth year, illustrate the shift from reactive to preventative medicine, enabling less extensive risk-reducing surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgad156","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T12:39:17Z","timestamp":1679056757000},"page":"e734-e742","source":"Crossref","is-referenced-by-count":32,"title":["The Changing Face of Multiple Endocrine Neoplasia 2A: From Symptom-Based to Preventative Medicine"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6796-079X","authenticated-orcid":false,"given":"Andreas","family":"Machens","sequence":"first","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, Faculty of Medicine, Martin Luther University Halle-Wittenberg , D-06097 Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0281-1950","authenticated-orcid":false,"given":"Kerstin","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, Faculty of Medicine, Martin Luther University Halle-Wittenberg , D-06097 Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2904-4341","authenticated-orcid":false,"given":"Tim","family":"Brandenburg","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, University of Duisburg-Essen , D-45122 Essen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"F\u00fchrer-Sakel","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, University of Duisburg-Essen , D-45122 Essen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, Division of Endocrine Surgery, University of Duisburg-Essen , D-45122 Essen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Dralle","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, Faculty of Medicine, Martin Luther University Halle-Wittenberg , D-06097 Halle (Saale) , Germany"},{"name":"Department of General, Visceral and Transplantation Surgery, Division of Endocrine Surgery, University of Duisburg-Essen , D-45122 Essen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"issue":"6","key":"2023081819564102400_dgad156-B1","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1056\/NEJMp1506241","article-title":"Public health in the precision-medicine era","volume":"373","author":"Bayer","year":"2015","journal-title":"N Engl J Med"},{"key":"2023081819564102400_dgad156-B2","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2020.543246","article-title":"5P Strategies for management of multiple endocrine neoplasia type 2: a paradigm of precision medicine","volume":"11","author":"Li","year":"2020","journal-title":"Front Endocrinol. 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