First population-based national eHealth system study on the prevalence of nonmalignant thyroid disorders in North Macedonia: A cross-sectional analysis

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Abstract
Objective: Thyroid disorders are among the most common endocrine conditions worldwide. However, in the Republic of North Macedonia, national level data on their prevalence and demographic distribution are lacking. This study aimed to determine the prevalence and demographic patterns of nonmalignant thyroid disorders using data from the National eHealth System. Methods: This retrospective, population-based , cross-sectional study analyzed 269,690 anonymized records of patients diagnosed with nonmalignant thyroid disorders, derived from the National eHealth System as of 31 October 2024. Diagnoses were identified using the International Classification of Diseases, 10th Revision codes E00–E07. Results: The overall national prevalence of nonmalignant thyroid disorders was 14.68%. Prevalence was higher in women (24.36%) than in men (4.85%) and increased with age, with the highest prevalence of 21.9% among those aged 60–79 years. Women had significantly higher odds of thyroid disorders than men (odds ratio: 6.32; 95% confidence interval: 6.25–6.38; p < 0.0001). Prevalence was higher in urban than in rural areas (17.1% vs. 10.9%). Hypothyroidism (E03) was the most common disorder, affecting 9.7% of the population. Conclusion: This is the first national level study to examine the epidemiology of nonmalignant thyroid disorders in the Republic of North Macedonia. The findings reveal marked variations in prevalence by sex, age, and place of residence, underscoring the need for targeted public health strategies and further investigation.

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