Thyroid Carcinoma and Nodular Goiter in a Community Hospital

Disagreement still continues as to the actual incidence of thyroid carcinoma in nodular goiter and, indeed, as to whether the two are truly related. Numerous investigators have reported series in which the incidence varies from 5% to as high as 17%.^1-4,7 These reports, however, have come from large medical centers, and the objection has been raised that selection has taken place before the patient arrives at such an institution, with the result that there is a higher proportion of goiters which are suspected of being malignant before operation. These figures, therefore, may not be representative of the occurrence of carcinoma in goitrous persons in the general population. This view is supported by a study carried out over a period of 25 years at the community level, in which in 379 thyroidectomies performed there was an incidence of carcinoma of 1.6%.¹¹ In an effort to cast further light upon