Prevalence of Thyroid Disorders in the Working Population of Germany: Ultrasonography Screening in 96,278 Unselected Employees

Abstract

Germany continues to be iodine deficient despite considerable improvement in the past years. To assess the current prevalence of diffuse and/or nodular thyroid disorders, a cross-sectional observational study in a nonrandom sample of the working population was carried out throughout Germany in 2001 and 2002. A total of 96,278 employees 18-65 years of age from 214 companies or other private or public institutions voluntarily underwent ultrasonographic examinations by 230 experienced investigators. To compare the prevalence of different abnormal findings in relation to age and gender, descriptive statistics and the Kruskal-Wallis test were used. Data from volunteers with previous thyroid treatment (13.0% of total sample) were not included in the analysis. Abnormal findings (goiter and/or nodules > 0.5 cm) were observed in 33.1% (men, 32.0%; women, 34.2%) of the examined patient population, an enlarged thyroid without nodules in 9.7% (men, 11.9%; women, 7.6%), nodules only without enlargement of the thyroid in 14.3% (men, 11.5%; women, 17.0%), and nodular goiter in 9.1% (men, 8.6%; women, 9.6%). Nodules (with or without goiter) between 0.5 and up to 1.0 cm were found in 10.0%, and nodules above 1.0 cm in 11.9% of the population. Rates of abnormal findings increased with age in both genders. Goiter was more common in men, nodules in women. In light of these findings, the prevalence of thyroid disorders in Germany continues to be high. Although the study may slightly overestimate the prevalence, about one third of the working population is affected and remains unaware of this condition. These results emphasize the importance of effective sonographic screening to detect early thyroid abnomalities in order to initiate preventive and therapeutic measures to prevent the onset or progression of disease and its sequels.

Geographic variations in the frequency of thyroid disorders and thyroid peroxidase antibodies in persons without former thyroid disease within Germany

“…Previous ultrasound studies from Germany on adults reported inconsistent results regarding the prevalence of thyroid ultrasound findings. While, for example, pathological changes of the thyroid (goiter/nodules and suspected autoimmune thyroiditis) in untreated persons were observed in 70% of the study conducted by Guth et al (34), the corresponding proportion was 33% in the Papillon study (35). A Finnish study conducted on middle-aged women found abnormalities of the thyroid gland as revealed by ultrasound examination in 35.6% (36).…”

Description of patients consulting the voice clinic regarding gender, age, occupational status, and diagnosis

“…The breakdown of students according to level of schooling was: 1.8% of preschool pupils (aged under 6), 36.7% of primary-school pupils (aged 6 to 11), 16.9% of secondary-school students (aged 12 to 17), and 44.6%…”

“…Etiologies of laryngeal mobility disorders include malignancies, surgery, and idiopathic causes. Prevalence of thyroid disorders increases with age and thyroid cancer mostly occurs after fifty years of age [35,36]. Cantarella et al showed that the main etiology of unilateral vocal fold paralysis was thyroidectomy in middle aged patients, head and neck surgery in elderly patients, and idiopathic origin in the youngest patients [35].…”

How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

“…Goiter and/or thyroid nodules are the most prevalent endocrine conditions in the world, affecting over 500 million people with prevalence rates reaching up to 30 % [1,2]; local neck symptoms range from 13 to 50 % in patients undergoing surgery for benign nodular diseases [3,4].…”