Screening and diagnosis of Cushing's syndrome

Screening studies in high-risk populations have suggested that Cushing's syndrome is more common than previously appreciated. Patients who have specific signs and symptoms or clinical diagnoses known to be associated with hypercortisolism should be considered for screening. The measurement of late-night salivary cortisol provides the most sensitive method for screening, and urine-free cortisol and low-dose dexamethasone suppression testing may be used for confirmation of the diagnosis of endogenous hypercortisolism.