TY - JOUR
T1 - Thyroidectomies in Italy: A Population-Based National Analysis from 2001 to 2018
AU - Pierannunzio, Daniela
AU - Fedeli, Ugo
AU - Francisci, Silvia
AU - De Paoli, Angela
AU - Toffolutti, Federica
AU - Serraino, Diego
AU - Zoppini, Giacomo
AU - Borsatti, Eugenio
AU - Di Felice, Enza
AU - Falcini, Fabio
AU - Ferretti, Stefano
AU - Giorgi Rossi, Paolo
AU - Gobitti, Carlo
AU - Guzzinati, Stefano
AU - Mattioli, Veronica
AU - Mazzoleni, Guido
AU - Piffer, Silvano
AU - Vaccarella, Salvatore
AU - Vicentini, Massimo
AU - Zorzi, Manuel
AU - Franceschi, Silvia
AU - Elisei, Rossella
AU - Dal Maso, Luigino
AU - Avossa, Francesco
AU - De Palma, Rossana
AU - Vattiato, Rosa
AU - Polverino, Andrea
AU - Vittadello, Fabio
AU - Fanetti, Giuseppe
AU - DEPTH Working Group
N1 - Funding Information:
This work was supported by the Italian Association for Cancer Research (AIRC; Grant No. 21879) and by the Italian Ministry of Health (Ricerca Corrente, RCR-2020-23670066, Alliance Against Cancer: Overdiagnosis, overtreatment, and outcome in cancer patients, WP 7). The funding sources had no involvement in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.
Publisher Copyright:
Copyright © 2022 Mary Ann Liebert, Inc.
PY - 2022/3
Y1 - 2022/3
N2 - Background: The incidence of thyroid disease is generally increasing, and it is subject to major geographic variability, between and within countries. Moreover, the incidence rates and the proportion of overdiagnosis for thyroid cancer in Italy are among the highest worldwide. This study aimed to estimate population-based frequency and trends of thyroidectomies in Italy by type of surgical procedure (total/partial), indication (tumors/other conditions), sex, age, and geographical region. Materials and Methods: Age-standardized rates (ASRs) of thyroidectomies were estimated from 2001 to 2018 using the national hospital discharges database. Results: In Italy, ASRs of thyroidectomies were nearly 100 per 100,000 women in 2002-2004 and decreased to 71 per 100,000 women in 2018. No corresponding variation was shown in men (ASR 27 per 100,000 men) in the overall period. A more than twofold difference between Italian regions emerged in both sexes. The proportion of total thyroidectomies (on the sum of total and partial thyroidectomies) in the examined period increased from 78% to 86% in women and from 72% to 81% in men. Thyroidectomies for goiter and nonmalignant conditions decreased consistently throughout the period (from 81 per 100,000 women in 2002 to 49 in 2018 and from 22 to 16 per 100,000 men), while thyroidectomies for tumors increased until 2013-2014 up to 24 per 100,000 women (9 per 100,000 men) and remained essentially stable thereafter. Conclusions: The decrease in thyroidectomies for nonmalignant diseases since early 2000s in Italy may derive from the decrease of goiter prevalence, possibly as a consequence of the reduction of iodine deficiency and the adoption of conservative treatments. In a context of overdiagnosis of thyroid cancer, recent trends have suggested a decline in the diagnostic pressure with a decrease in geographic difference. Our results showed the need and also the possibility to implement more conservative surgical approaches to thyroid diseases, as recommended by international guidelines.
AB - Background: The incidence of thyroid disease is generally increasing, and it is subject to major geographic variability, between and within countries. Moreover, the incidence rates and the proportion of overdiagnosis for thyroid cancer in Italy are among the highest worldwide. This study aimed to estimate population-based frequency and trends of thyroidectomies in Italy by type of surgical procedure (total/partial), indication (tumors/other conditions), sex, age, and geographical region. Materials and Methods: Age-standardized rates (ASRs) of thyroidectomies were estimated from 2001 to 2018 using the national hospital discharges database. Results: In Italy, ASRs of thyroidectomies were nearly 100 per 100,000 women in 2002-2004 and decreased to 71 per 100,000 women in 2018. No corresponding variation was shown in men (ASR 27 per 100,000 men) in the overall period. A more than twofold difference between Italian regions emerged in both sexes. The proportion of total thyroidectomies (on the sum of total and partial thyroidectomies) in the examined period increased from 78% to 86% in women and from 72% to 81% in men. Thyroidectomies for goiter and nonmalignant conditions decreased consistently throughout the period (from 81 per 100,000 women in 2002 to 49 in 2018 and from 22 to 16 per 100,000 men), while thyroidectomies for tumors increased until 2013-2014 up to 24 per 100,000 women (9 per 100,000 men) and remained essentially stable thereafter. Conclusions: The decrease in thyroidectomies for nonmalignant diseases since early 2000s in Italy may derive from the decrease of goiter prevalence, possibly as a consequence of the reduction of iodine deficiency and the adoption of conservative treatments. In a context of overdiagnosis of thyroid cancer, recent trends have suggested a decline in the diagnostic pressure with a decrease in geographic difference. Our results showed the need and also the possibility to implement more conservative surgical approaches to thyroid diseases, as recommended by international guidelines.
KW - age-standardized rates
KW - Italy
KW - thyroid surgery
KW - thyroidectomies
KW - time trends
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U2 - 10.1089/thy.2021.0531
DO - 10.1089/thy.2021.0531
M3 - Article
C2 - 35018816
AN - SCOPUS:85127573567
SN - 1050-7256
VL - 32
SP - 263
EP - 272
JO - Thyroid
JF - Thyroid
IS - 3
ER -