TY - JOUR
T1 - Trends in thyroid function testing, neck ultrasound, thyroid fine needle aspiration, and thyroidectomies in North-eastern Italy
AU - DEPTH Working Group
AU - Dal Maso, L
AU - Panato, C
AU - De Paoli, A
AU - Mattioli, V
AU - Serraino, D
AU - Elisei, R
AU - Zoppini, G
AU - Gobitti, C
AU - Borsatti, E
AU - Di Felice, E
AU - Falcini, F
AU - Ferretti, S
AU - Francisci, S
AU - Giorgi Rossi, P
AU - Guzzinati, S
AU - Mazzoleni, G
AU - Pierannunzio, D
AU - Piffer, S
AU - Vaccarella, S
AU - Vicentini, M
AU - Zorzi, M
AU - Franceschi, S
AU - Fedeli, U
N1 - © 2021. The Author(s).
PY - 2021/8
Y1 - 2021/8
N2 - PURPOSE: Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy.METHODS: A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region.RESULTS: Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013.CONCLUSIONS: The results of this population-based study describe recent variations over time and between surrounding areas of indicators of 'diagnostic pressure' on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.
AB - PURPOSE: Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy.METHODS: A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region.RESULTS: Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013.CONCLUSIONS: The results of this population-based study describe recent variations over time and between surrounding areas of indicators of 'diagnostic pressure' on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.
KW - Adult
KW - Aged
KW - Biopsy, Fine-Needle/methods
KW - Female
KW - Humans
KW - Italy/epidemiology
KW - Male
KW - Medical Overuse/prevention & control
KW - Patient Acceptance of Health Care/statistics & numerical data
KW - Population Surveillance
KW - Sex Factors
KW - Thyroid Diseases/diagnosis
KW - Thyroid Function Tests/methods
KW - Thyroid Gland/diagnostic imaging
KW - Thyroidectomy/methods
KW - Ultrasonography/methods
U2 - 10.1007/s40618-020-01475-3
DO - 10.1007/s40618-020-01475-3
M3 - Article
C2 - 33460012
SN - 0391-4097
VL - 44
SP - 1679
EP - 1688
JO - Journal of Endocrinological Investigation
JF - Journal of Endocrinological Investigation
IS - 8
ER -