title: Epidemiology and histology of malignant thyroid nodules in North East Region of Romania (Moldavia) before and after alimentary salt universal iodination.
abstract: Research on the relationship between iodine exposure and thyroid cancer risk is limited and the findings are inconclusive.
  
  
  OBJECTIVE
  Given this molecular data on iodine we decided to evaluate the changes of incidence and histology of thyroid cancer in the North-Eastern region of Romania (Moldavia) after the government decision from 2004 that introduced the universal iodination of alimentary salt. After this decision values of urinary iodine increased from 50 microg/L (2001-2002) to 117 microg/L (2006 -2008).
  
  
  METHODS
  We compared the incidence and the histology of thyroid cancer in residents living in an area known as a mild endemic goiter region (Moldavia-Romania) between 2001-2004 with the incidence and the histology of thyroid cancer between 2005-2008 in the same region after the introduction of universal iodization of alimentary salt.
  
  
  RESULTS
  The number of papillary cancers increased from 125 cases (2001-2004) to 276 cases (2005-2008). The number of follicular cancer decreased from 52 cases (2001-2004) to 27 cases (2005-2008). The ratio between papillary and follicular cancers increased from 4.80 / 1 (2001-2004) at 10.61 / 1 (2005-2008). The number of medullar thyroid carcinoma increased from six cases (2001-2004) to 24 cases (2005-2008). Thyroid anaplastic carcinomas number increased from 7 cases (2001-2004) to 12 cases (2005-2008). The total number of thyroid cancer has increased dramatically after the introduction of universal iodination of alimentary salt with 178% compared to 2001-2004 (from 190 cases in 2001-2004 to 339 cases in 2005-2008), despite the fact that the number thyroidectomies decreased from 1734 (2001-2004) to 1449 (2005-2008).
  
  
  CONCLUSIONS
  After the introduction the universal iodination of alimentary salt starting from 2004 the total number of thyroid cancers increased comparative with the period before universal iodination of alimentary salt.
authors.affiliation: Department of Endocrinology, "Gr.T. Popa" University of Medicine and Pharmacy, Iaşi.
authors.forename: C
authors.initials: C
authors.lastname: Buzduga
authors.forename: Voichiţa
authors.initials: V
authors.lastname: Mogoş
authors.forename: Corina
authors.initials: C
authors.lastname: Găleşanu
authors.forename: Carmen
authors.initials: C
authors.lastname: Vulpoi
authors.forename: M
authors.initials: M
authors.lastname: Ungureanu
authors.forename: C
authors.initials: C
authors.lastname: Cristea
authors.forename: Cristina
authors.initials: C
authors.lastname: Preda
authors.forename: D
authors.initials: D
authors.lastname: Ciobanu
authors.forename: D
authors.initials: D
authors.lastname: Ferariu
authors.forename: Niculina
authors.initials: N
authors.lastname: Florea
authors.forename: E
authors.initials: E
authors.lastname: Zbranca
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000453:epidemiology / Q000473:pathology; D000231:Adenocarcinoma, Papillary / Q000453:epidemiology / Q000473:pathology; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology; D018276:Carcinoma, Medullary / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015994:Incidence; D007455:Iodine / Q000008:administration & dosage / Q000009:adverse effects*; D016017:Odds Ratio; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage / Q000009:adverse effects*; D013964:Thyroid Neoplasms / Q000178:diet therapy / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D016606:Thyroid Nodule / Q000453:epidemiology / Q000473:pathology; D013965:Thyroidectomy
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine