Mortality from thyrotoxicosis in England and Wales and its association with the previous prevalence of endemic goitre.

The distribution of mortality from thyrotoxicosis among women in England and Wales during 1968-78 correlates with the previous prevalence of endemic goitre. Mortality from the disease rose to a peak in the decade 1931-40 and then declined. This peak affected all age groups and can be attributed to the high fatality from surgery before the introduction of preoperative iodine to prevent thyroid crisis. An apparent cohort effect, whereby cohorts born from 1871 to 1886 experienced the highest mortality, may be explained by generations with a high prevalence of endemic goitre becoming exposed to increasing dietary iodine intake in later life.