Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany
Abstract Following implementation of a national prevention program against iodine deficiency-related disorders in 1993 in Germany, the prevalence of thyroid disorders declined, but aggregated drug dispensation data suggested a recent increase in thyroid hormone use. We aimed to systematically invest...
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Nature Portfolio
2024-11-01
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| author | Arulmani Thiyagarajan Niklas Koenen Till Ittermann Henry Völzke Ulrike Haug |
| author_facet | Arulmani Thiyagarajan Niklas Koenen Till Ittermann Henry Völzke Ulrike Haug |
| author_sort | Arulmani Thiyagarajan |
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| description | Abstract Following implementation of a national prevention program against iodine deficiency-related disorders in 1993 in Germany, the prevalence of thyroid disorders declined, but aggregated drug dispensation data suggested a recent increase in thyroid hormone use. We aimed to systematically investigate trends in the use of thyroid diagnostic and treatment measures between 2008 and 2019 in Germany. Using the GePaRD database (claims data from ~ 20% of the German population), we determined the annual age-specific and age-standardized prevalence of the use of thyroid diagnostics (thyroid-stimulating hormone (TSH) measurement, thyroid ultrasound, scintiscan, biopsy) and treatment (medication, surgery, radioiodine therapy) from 2008 to 2019 stratified by sex. Between 2008 and 2019, the age-standardized prevalence of TSH measurement increased by 36% in males (from 165 to 225 per 1,000 persons) and by 24% in females (from 295 to 367 per 1,000). The prevalence of thyroid ultrasound use showed no clear time trend, while there was a decrease in the prevalence of scintiscan use (males/females: decrease by 42/43%) and biopsy (males/females: decrease by 42/34%). The prevalence of levothyroxine use increased by ~ 31% both in males (from 36 to 47 per 1,000) and females (from 134 to 175 per 1,000), while the prevalence of thionamide use, iodine use, thyroidectomy, and radioiodine therapy decreased. Our study suggests a continued decline in the prevalence of clinically significant thyroid disorders between 2008 and 2019. The substantial increase in the prevalence of TSH measurement and levothyroxine use during this time period might indicate overuse of diagnostics and overtreatment, warranting further investigation. |
| format | Article |
| id | doaj-art-0f7fccc32d5941bab18b5ff1db74334d |
| institution | OA Journals |
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| spelling | doaj-art-0f7fccc32d5941bab18b5ff1db74334d2025-08-20T02:00:03ZengNature PortfolioScientific Reports2045-23222024-11-011411910.1038/s41598-024-77896-4Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in GermanyArulmani Thiyagarajan0Niklas Koenen1Till Ittermann2Henry Völzke3Ulrike Haug4Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPSDepartment of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology – BIPSInstitute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPSAbstract Following implementation of a national prevention program against iodine deficiency-related disorders in 1993 in Germany, the prevalence of thyroid disorders declined, but aggregated drug dispensation data suggested a recent increase in thyroid hormone use. We aimed to systematically investigate trends in the use of thyroid diagnostic and treatment measures between 2008 and 2019 in Germany. Using the GePaRD database (claims data from ~ 20% of the German population), we determined the annual age-specific and age-standardized prevalence of the use of thyroid diagnostics (thyroid-stimulating hormone (TSH) measurement, thyroid ultrasound, scintiscan, biopsy) and treatment (medication, surgery, radioiodine therapy) from 2008 to 2019 stratified by sex. Between 2008 and 2019, the age-standardized prevalence of TSH measurement increased by 36% in males (from 165 to 225 per 1,000 persons) and by 24% in females (from 295 to 367 per 1,000). The prevalence of thyroid ultrasound use showed no clear time trend, while there was a decrease in the prevalence of scintiscan use (males/females: decrease by 42/43%) and biopsy (males/females: decrease by 42/34%). The prevalence of levothyroxine use increased by ~ 31% both in males (from 36 to 47 per 1,000) and females (from 134 to 175 per 1,000), while the prevalence of thionamide use, iodine use, thyroidectomy, and radioiodine therapy decreased. Our study suggests a continued decline in the prevalence of clinically significant thyroid disorders between 2008 and 2019. The substantial increase in the prevalence of TSH measurement and levothyroxine use during this time period might indicate overuse of diagnostics and overtreatment, warranting further investigation.https://doi.org/10.1038/s41598-024-77896-4Thyroid diagnosticsThyroid treatmentsAge-specific prevalenceAge-standardized prevalenceGermany |
| spellingShingle | Arulmani Thiyagarajan Niklas Koenen Till Ittermann Henry Völzke Ulrike Haug Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany Scientific Reports Thyroid diagnostics Thyroid treatments Age-specific prevalence Age-standardized prevalence Germany |
| title | Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany |
| title_full | Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany |
| title_fullStr | Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany |
| title_full_unstemmed | Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany |
| title_short | Trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in Germany |
| title_sort | trends in the use of thyroid diagnostics and treatments between 2008 and 2019 in germany |
| topic | Thyroid diagnostics Thyroid treatments Age-specific prevalence Age-standardized prevalence Germany |
| url | https://doi.org/10.1038/s41598-024-77896-4 |
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