How many people in the world have pigeon chests? Understanding the prevalence of pectus carinatum

September 27, 2025 •

3 min read

Precise global statistics on how many people in the world have pigeon chests, or pectus carinatum, are elusive due to diagnostic inconsistencies and the condition often being mild or unnoticed, though medical literature provides important insights into its occurrence.

Quick Summary

Estimates for the prevalence of pectus carinatum vary, with some studies indicating it affects as few as 1 in 1,500 children, though more robust data is limited, making global figures difficult to determine definitively.

Key Points

Prevalence Varies: Global estimates for pectus carinatum (pigeon chest) are unreliable, with figures for children ranging from approximately 1 in 1,000 to 1 in 1,500, and overall prevalence being challenging to track.
Gender Disparity: The condition is significantly more common in males, with some studies showing men are affected up to four to seven times more frequently than women.
Puberty Onset: Pectus carinatum is often noticed or worsens during the adolescent growth spurt, between the ages of 11 and 14, even if present at birth.
Bracing is Common: For teens with a flexible chest wall, non-invasive bracing is a highly effective treatment option that gradually reshapes the sternum.
Associated Conditions: The condition can be linked with other health issues, including Marfan syndrome, Noonan syndrome, and scoliosis, suggesting a possible genetic component.
Underestimated Cases: Studies using CT scans suggest the true number of cases may be higher than estimates based on visual observation, as many mild or asymmetrical cases might be missed.

The Challenge of Pinpointing a Global Figure

Estimating the global prevalence of a condition like pectus carinatum is inherently complex. Factors such as the absence of large-scale, population-based studies and the fact that diagnosis is often based on visual examination make gathering precise data difficult. The dynamic nature of the deformity, which can become more prominent during adolescence, also complicates tracking. Furthermore, there is limited awareness among the general public and even some healthcare providers, which can lead to underreporting or misdiagnosis. For these reasons, different medical sources offer a range of prevalence estimates.

What Medical Statistics Say

Medical literature offers several figures regarding how common pectus carinatum is. It is widely considered less common than its counterpart, pectus excavatum (sunken chest), occurring in only a fraction of pectus malformation cases.

Live Birth Incidence: One commonly cited figure suggests the condition occurs in approximately 1 in 1,500 live births. However, another source cites a broader range of 1 in 1,000 to 1,500 live births, acknowledging geographical variations.
General Population Prevalence: Some estimates suggest an overall prevalence rate as low as 0.06%. This number likely underestimates the true prevalence, as many mild cases go uncounted.
CT Study Findings: Interestingly, studies using computed tomography (CT) to detect asymmetrical cartilage prominence have reported much higher prevalence rates, ranging from 2% to 5%. This suggests that the visual examination often used for diagnosis may miss many cases.

Understanding Demographics and Causes

While the exact global number is uncertain, the demographic patterns of pectus carinatum are well-documented.

Gender: The condition is significantly more common in males than in females, with male-to-female ratios ranging from 4:1 to 7:1.
Age of Onset: While some cases are present at birth, pectus carinatum often becomes more obvious during the adolescent growth spurt, typically between the ages of 11 and 14, as rapid growth can worsen the chest's protrusion.
Etiology (Cause): The specific cause is unknown, but a genetic component is strongly suspected. It is not uncommon for several family members to have some form of chest wall deformity. Pectus carinatum is also associated with certain genetic syndromes, including Marfan syndrome, Noonan syndrome, and scoliosis.

Pectus Carinatum vs. Pectus Excavatum: A Comparison

To fully understand the context of pectus carinatum, it is helpful to compare it to the more common pectus excavatum.


Feature	Pectus Carinatum (Pigeon Chest)	Pectus Excavatum (Sunken Chest)
Appearance	Breastbone and ribs protrude outward.	Breastbone is sunken or indented.
Prevalence	Less common, estimated incidence 1 in 1,500 births.	More common, estimated incidence 1 in 500 births.
Gender Ratio	Significantly more common in males (4:1).	Also more common in males (3-5:1).
Typical Symptoms	Often asymptomatic, but can cause chest pain, shortness of breath during exercise, and cosmetic concerns.	Can cause shortness of breath, chest pain, and heart palpitations, especially with exertion.
Initial Treatment	Often treated with an external chest wall brace.	Can sometimes require surgery sooner due to potential cardiac issues.

Medical Management and Treatment

For many, pectus carinatum is a cosmetic concern. However, in more severe cases, it can cause physical symptoms. Fortunately, there are effective treatment options available.

Bracing: For adolescents with a flexible chest wall, an external brace is a common and successful non-invasive treatment. Worn for many hours daily, the brace applies gentle, continuous pressure to slowly reshape the chest over several months or years.
Surgery: Surgical correction is typically reserved for severe cases, those with rigid chests, or when bracing fails. The Ravitch procedure is one common surgical approach where surgeons reshape the cartilage and ribs.

The Evolving Understanding of Pectus Carinatum

Despite the lack of a single, precise global figure for how many people in the world have pigeon chests, research continues to improve our understanding of this condition. Advances in diagnostic imaging, like CT scans, reveal a higher subclinical prevalence than previously thought. The increasing focus on connective tissue disorders and genetic links also contributes to more holistic care. Furthermore, addressing the psychological impact of the deformity, which can lead to low self-confidence, is now a crucial part of patient care. By compiling data from various reputable medical sources, we can gain a clearer picture of this complex and often misunderstood chest wall deformity.

For more in-depth information on pectus carinatum and other chest wall deformities, the National Institutes of Health provides a vast resource of medical literature.

Frequently Asked Questions

Pectus carinatum, or pigeon chest, is characterized by an outward protrusion of the breastbone and ribs. Pectus excavatum, also known as sunken or funnel chest, is a condition where the breastbone and ribs grow inward instead.

Yes, for many adolescent patients with a flexible chest wall, a non-invasive external chest brace is a very effective treatment. It works similarly to dental braces by applying pressure to reshape the chest wall over time.

Most cases are primarily cosmetic. However, some individuals with pectus carinatum may experience symptoms like chest pain, pain in their ribs or back, and sometimes shortness of breath, particularly during strenuous exercise.

The exact cause of pectus carinatum is unknown, but a genetic link is suspected. It is common for a family history of chest wall deformities to exist, and the condition can be associated with several genetic syndromes.

While it can be present at birth, pectus carinatum most commonly becomes noticeable or worsens during the adolescent growth spurt, with peak presentation often between ages 11 and 14.

A doctor can diagnose pectus carinatum through a physical examination. To assess severity and rule out other issues, they may order imaging tests such as a chest X-ray, CT scan, or MRI.

Some sources, like Medscape, report that pectus carinatum is more frequent among white populations and less common in Black and Asian populations, although more extensive research is needed.