C mon disease. The incidence based on statistics from death certificates shows that the death rate in this disease is approximately one per lOO, OOO. 5 Of course, these figures do not show the prevalence of the disease among the living. This is unknown because published statistics vary so greatly. The reported occurrence of carcinoma in nontoxic nodular goiters varies from 3.6 to 17.1y0 and in solitary nodules from 9 to 33y0.1. 2943 6 These data concern only surgical patients and do not apply to the general population.
The wide variation in figures is due to inaccuracy in distinguishing clinically between single and multiple nodules of the thyroid and to the unavoidable selection of cases. Some of the disparity is aIso due to the lack of uniform criteria for evaluating pathologic findings. Certainly the low incidence of malignant tumors in some areas reflects the failure of pathologists to recognize cancer of the thyroid.
PROBABLE POPULATION WITH DISEASE
For more than 50 years it has been assumed that cancer of the thyroid was more frequent in goitrous than in nongoitrous regions. No large-scale investigation has been carried out but the few limited surveys conducted in the last 15 years indicate that cancer of the thyroid is equally distributed throughout all areas and has no relationship to goitrous regions. The reported inequality appears to be related to local interest in the disease rather than any geographic differences.
Carcinoma of the thyroid rarely is associ-