STUDIES in geographic pathology provide exceptional opportunities to examine familiar diseases in special environments in which there may be significant local differences in important variables. Particularly fertile fields for inquiry are found in some developing countries in which geographically limited populations often represent a stage of health care no longer extant in other parts of the world.
Northern Thailand is an area in Southeast Asia in which iodine deficiency goiter is endemic.1 Iodized salt was not made available to the population of this region until late 1965, and then only in very limited areas.1 In addition, the affected population is not geographically mobile and patients with thyroid disease tend to reside in areas in which they were born.
Diseases of the thyroid are an unusually good example of changing patterns of health: thyrotoxicosis2,3 and nodular colloid goiter are declining4 while there is an increasing incidence of
Headington JT, Tantajumroon T. Surgical Thyroid Disease in Northern ThailandA Study in Geographic Pathology. Arch Surg. 1967;95(1):157-161. doi:10.1001/archsurg.1967.01330130159031