A population-based study on thyroidectomies in Mexico from 2010 to 2023

Background . Thyroid cancer is the fourth most common cancer in Mexico. Overdiagnosis and subsequent overtreatment have increased as diagnostic tests have become more readily available. Also, an increasing share of total thyroidectomies relative to partial thyroidectomies was observed in many high-income countries in the early 2000s. There is limited understanding of the frequency of thyroidectomies and surgical approach in low- and middle-income countries. We aimed to estimate time trends and geographic patterns of thyroidectomies in Mexico by sex, age groups, type of procedure (total and partial thyroidectomies), and discharge diagnosis. Methods . We used a national hospital discharge database collected by the Ministry of Health for individuals without health insurance coverage from 2010 to 2023. We identified hospital discharges where a total (ICD-9: 064X, 0650, 0652) or partial (ICD-9: 0639, 0651) thyroidectomy were performed. We classified discharge diagnoses into four groups: malignant neoplasms, benign tumors, goiter and thyroid-related morbidities, and other diagnoses unrelated to the thyroid. We calculated crude and age-standardized incidence rates for men and women by region in Mexico (North, Central, Southeast, West, and Mexico City) and for three time periods: 2010-2012, 2013-2018, and 2018-2023. Results . The national standardized rate of thyroidectomies was 4.8 per 100,000 in women and 0.74 in men. The rate showed a downward trend throughout the period, particularly among women with goiter. Overall, the rate of thyroidectomies for malignant disease remained stable, however, the percentage of thyroidectomies for malignant tumors increased in both women (34.3%, 36.0%, and 45.2%) and men (36.6%, 43.6%, and 51.7%) when comparing the three periods. We observed important regional differences, with the highest rate in Mexico City (17.9 per 100,000 in women) and the lowest in the central region. The proportion of total thyroidectomies in the examined period increased from 49% to 63% in women and from 47% to 66% in men. Conclusions . The downward trend in thyroidectomies in Mexico may be the result in changing guidelines. Our results do not reveal thyroid cancer overdiagnosis but show potential for more conservative surgical treatment.