Ethnic disparities in thyroid surgery outcomes in New Zealand

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There is ethnic variability in the incidence of thyroid disease in New Zealand. Gibbons et al. found that thyroid dysfunction affected about 3.1% of the general population in Waikato, a provincial region of New Zealand. The prevalence was greater among the Europeans (3.5%) than in Māori (2.1%), Pacific Islanders (1.8%) or Asians (1.8%), although differences were not significant after adjusting for age and gender.1 Elston et al. noted that Asians, Māori and Pacific Islanders are at particular risk of thyrotoxic, hypokalaemic periodic paralysis, a rare complication of thyroid disease, when compared with New Zealand Europeans.2 Meredith et al. highlighted that Pacific Island women in particular have high rates of thyroid cancer compared with their Māori and European counterparts.3 It is unclear why such differences exist, although genetic, metabolic (obesity) and dietary factors have been proposed.1
Racial disparities in clinical and economic outcomes from thyroid surgery in the United States have been noted, but this has generally not been examined in other countries.4 In any event, it is unclear whether the data from the international literature apply to the New Zealand population due to differences in dietary iodine intake, population structure, ethnic variations and variance in laboratory indices for thyroid function.
This study aims to examine the differences in clinical characteristics, outcomes and demographic profiles of European, Māori and Pacific Islander patients undergoing thyroid surgery in south Auckland.
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