The incidence of adrenal tumors has increased 10-fold over the past 2 decades, in parallel to the growing number of computed tomography (CT) abdominal scans (1). The observed increase in the incidence of adrenal tumors was mainly due to more frequent discovery of smaller adrenal incidentalomas in older patients (1). However, because an abdominal CT scan is usually ordered to evaluate a medical concern, imaging bias is very likely in any prevalence study that relies on the availability of imaging (1–5). Another concern is underreporting of adrenal lesions noted on CT scans.
