Trends and Regional Variation in Rates of Thyroidectomy in Australia

Area of Science:

• Endocrinology
• Surgical Oncology
• Public Health

Background:

• Thyroid disease incidence has risen globally, yet mortality rates remain stable.
• Assessing thyroid procedure trends and geographic variations in Australia is crucial.
• The introduction of American Thyroid Association (ATA) Guidelines in 2015 provides a temporal marker for practice changes.

Purpose of the Study:

• To analyze trends in thyroidectomy procedures (total, hemi-, partial) in Australia from 2014-2023.
• To evaluate geographic variations in thyroidectomy rates across Australian states.
• To investigate the impact of the 2015 ATA Guidelines on thyroid surgery practices.

Main Methods:

• Utilized Medicare Benefits Scheme (MBS) data for thyroidectomy items (30296, 30306, 30310) between January 2014 and December 2023.
• Calculated per capita frequencies for total and partial thyroidectomy subgroups.
• Assessed temporal trends and geographic variability in procedure rates.

Main Results:

• Overall thyroid procedures showed no significant annual increase (2014 vs. 2023).
• Partial thyroidectomies significantly increased (p<0.01), while total thyroidectomies significantly decreased (p<0.01).
• Significant geographic variation in per-capita thyroidectomy rates was observed across states (up to 300% difference).

Conclusions:

• The shift towards partial thyroidectomies and decreased total thyroidectomies may reflect the influence of ATA Guidelines.
• The guidelines potentially reduced physician-driven geographic variability and de-escalated procedures for low-risk cases.
• Multifactorial influences, including socioeconomic status and healthcare access, contribute to observed geographic variations.