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Cited by 2,432Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey

Vanderpump, M. P. J., Tunbrldge, W. M. G., French, J. M., Appleton, D., Bates, D., Clark, F., Evans, J. Grimley, Hasan, D. M. +3 more·1995·Clinical Endocrinology
DOI 10.1111/j.1365-2265.1995.tb01894.x
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Abstract

BACKGROUND AND OBJECTIVE: The original Whickham Survey documented the prevalence of thyroid disorders in a randomly selected sample of 2779 adults which matched the population of Great Britain in age, sex and social class. The aim of the twenty-year follow-up survey was to determine the incidence and natural history of thyroid disease in this cohort. DESIGN, PATIENTS AND MEASUREMENTS: Subjects were traced at follow-up via the Electoral Register, General Practice registers, Gateshead Family Health Services Authority register and Office of Population Censuses and Surveys. Eight hundred and twenty-five subjects (30% of the sample) had died and, in addition to death certificates, two-thirds had information from either hospital/General Practitioner notes or post-mortem reports to document morbidity prior to death. Of the 1877 known survivors, 96% participated in the follow-up study and 91% were tested for clinical, biochemical and immunological evidence of thyroid dysfunction. RESULTS: Outcomes in terms of morbidity and mortality were determined for over 97% of the original sample. The mean incidence (with 95% confidence intervals) of spontaneous hypothyroidism in women was 3.5/1000 survivors/year (2.8-4.5) rising to 4.1/1000 survivors/year (3.3-5.0) for all causes of hypothyroidism and in men was 0.6/1000 survivors/year (0.3-1.2). The mean incidence of hyperthyroidism in women was 0.8/1000 survivors/year (0.5-1.4) and was negligible in men. Similar incidence rates were calculated for the deceased subjects. An estimate of the probability of the development of hypothyroidism and hyperthyroidism at a particular time, i.e. the hazard rate, showed an increase with age in hypothyroidism but no age relation in hyperthyroidism. The frequency of goitre decreased with age with 10% of women and 2% of men having a goitre at follow-up, as compared to 23% and 5% in the same subjects respectively at the first survey. The presence of a goitre at either survey was not associated with any clinical or biochemical evidence of thyroid dysfunction. In women, an association was found between the development of a goitre and thyroid-antibody status at follow-up, but not initially. The risk of having developed hypothyroidism at follow-up was examined with respect to risk factors identified at first survey. The odds ratios (with 95% confidence intervals) of developing hypothyroidism with (a) raised serum TSH alone were 8 (3-20) for women and 44 (19-104) for men; (b) positive anti-thyroid antibodies alone were 8 (5-15) for women and 25 (10-63) for men; (c) both raised serum TSH and positive anti-thyroid antibodies were 38 (22-65) for women and 173 (81-370) for men. A logit model indicated that increasing values of serum TSH above 2mU/l at first survey increased the probability of developing hypothyroidism which was further increased in the presence of anti-thyroid antibodies. Neither a positive family history of any form of thyroid disease nor parity of women at first survey was associated with increased risk of developing hypothyroidism. Fasting cholesterol and triglyceride levels at first survey when corrected for age showed no association with the development of hypothyroidism in women. CONCLUSIONS: This historical cohort study has provided incidence data for thyroid disease over a twenty-year period for a representative cross-sectional sample of the population, and has allowed the determination of the importance of prognostic risk factors for thyroid disease identified twenty years earlier.

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Crossref · 10.1111/j.1365-2265.1995.tb01894.x

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  • Hypothyroidism (subclinical and overt) is approximately 10-times more common in women than men.

    “Hypothyroidism (subclinical and overt) is approximately 10-times more common in women than men, 31”

    From Hypothyroidism (2024) · cites this paper as [31]

  • In iodine-sufficient countries, the prevalence of overt hypothyroidism is approximately 1-2%.

    “In iodine-sufficient countries, the prevalence of overt hypothyroidism is approximately 1-2%.3,31- 33”

    From Hypothyroidism (2024) · cites this paper as [31]

  • Longitudinal data from the UK suggest an incidence rate of spontaneous hypothyroidism of 3.5-5.0 per 1000 women and 0.6-1.0 per 1000 men.

    “Longitudinal data from the UK suggest an incidence rate of spontaneous hypothyroidism of 3•5-5•0 per 1000 women and 0•6-1•0 per 1000 men.31,38”

    From Hypothyroidism (2024) · cites this paper as [31]

  • Around 5% of people with subclinical hypothyroidism will progress to overt hypothyroidism annually if serum thyroid peroxidase antibodies (TPOAb) are positive.

    “around 5% will progress to overt hypothyroidism annually, if serum thyroid peroxidase antibodies (TPOAb) are positive. 13”

    From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [13]

  • Subclinical hypothyroidism affects 5%-10% of the population.

    “Subclinical hypothyroidism affects 5% -10% of the population”

    From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [13]

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Authors
Vanderpump, M. P. J., Tunbrldge, W. M. G., French, J. M., Appleton, D., Bates, D., Clark, F., Evans, J. G., Hasan, D. M., Rodgers, H., Tunbridge, F., & Young, E. T.
Affiliations
  • Newcastle University (GB)
  • University of Oxford (GB)
  • Freeman Hospital (GB)
  • Wansbeck General Hospital (GB)
Corresponding author
Vanderpump, M. P. J.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
1995-07
Volume
43
Issue
1
Pages
55-68
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.1995.tb01894.x
OpenAlex
W2133547068
Cited by
2,432
References
47
Citations by year
2026: 41 · 2025: 59 · 2024: 66 · 2023: 70 · 2022: 113 · 2021: 80 · 2020: 124 · 2019: 102 · 2018: 98 · 2017: 120 · 2016: 104 · 2015: 102 · 2014: 108 · 2013: 118 · 2012: 116
FWCI
15.68
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4746 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Novo Nordisk
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
thyroid disease incidence, hypothyroidism, hyperthyroidism, goiter, thyroid autoantibodies, hazard function, age-related risk, sex differences, community-based cohort, mortality, thyroid dysfunction screening, iodine deficiency, iodized salt, iodine supplementation, goitre treatment
MeSH terms
Adult, Aged, Aged, 80 and over, Autoantibodies, England, Female, Follow-Up Studies, Goiter, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Morbidity, Risk Factors, Thyroid Diseases, Thyroid Gland, Thyrotropin, Incidence, Age Distribution, Sex Distribution

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