Prevalence and Distribution of Goiter Among Commercially Insured, Working-Age Adults in the United States

We report a cross-sectional analysis of prevalence and distribution of goiter among commercially insured adults ages 18-64 in the United States using the 2022-2023 Merative™ MarketScan^® Commercial Claims and Encounters Database.

Cases of goiter were identified using ICD-10 diagnosis codes. Prevalence was estimated under nested case definitions and by goiter subtype. Estimates were compared across U.S. Census regions. Multivariable regression was used to model the association of demographic, clinical, and regional variables on goiter prevalence.

Among 15.2 million commercially insured adults enrolled in MarketScan on December 31, 2023, overall goiter prevalence was 12.7-24.6 per 1000 persons. Prevalence was substantially higher among women and increased steadily with age. Non-toxic multinodular goiter accounted for most cases. Prevalence varied by U.S. Census region after adjusting for age, sex, toxic status, and diagnostic intensity.

The prevalence of goiter, comprised predominantly of non-toxic multinodular goiter, is estimated to be 1.3-2.5% among working-age adults in the U.S. and varies by sex, age, and potentially by geography. Further research is needed to investigate environmental and social drivers of the goiter burden.