Thyroid disease is a major public health concern for the Asia-Pacific region (APAC), requiring urgent action. The most common form—hypothyroidism—affects an estimated 11% of adults, compared with 2-4% of adults elsewhere.
Thyroid disease is an umbrella term for several conditions that occur due to abnormal thyroid functioning and production of hormones. They include hypothyroidism, hyperthyroidism, congenital hypothyroidism and, more rarely, thyroid cancer. Several population groups are at increased risk of thyroid disease, including pregnant women, newborns, older adults and individuals with certain genetic conditions.
Living with thyroid disease can be challenging, especially when undiagnosed, as the conditions impact physical, mental and social functions and quality of life. Economically, they also pose significant and increasing costs to national budgets and health systems. To research this topic, Economist Impact conducted an evidence review and convened a panel of experts to explore the central issues in the region and support the identification and development of the key policy areas.
The following policy takeaways provide the next steps to support a comprehensive, equitable and sustainable approach to addressing thyroid disease throughout APAC:
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Implement data gathering through surveillance. Why? Understanding the scale of the challenge is necessary to develop a tailored, evidence-based response to address it. How? Regularly surveying iodine levels and thyroid prevalence enables health authorities to gauge the scale of thyroid disease and what interventions are needed where. Piloting new approaches such as targeted screening and testing innovations will help determine their feasibility and clinical/cost-effectiveness.
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Focus screening on high-risk groups. Why? Targeting known high-risk groups will help improve overall detection of thyroid disease. How? High-risk groups, such as pregnant women, should be actively screened to improve detection. Integrating thyroid screening into existing programmes and services is a potentially cost and resource efficient route to improved detection for exploration.
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Raise awareness amongst the public and healthcare professionals. Why? Recognising thyroid disease depends on heightened awareness and proactive diagnostic screening. How? Educating primary care professionals and the public could lead to more people considering thyroid disease as the cause of non-specific symptoms. Other routes to raising awareness are evidence-based clinical guidelines and categorising thyroid disease as an NCD.
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Collaborate on standardised regional clinical guidelines. Why? Guidelines are easier to implement when they reflect real-world practice and relevant stakeholder perspectives. How? Developing regional guidelines could support resource-limited countries by enabling them to pool resources and expertise. Involving all relevant stakeholders—especially patients—is best practice in guideline production. Working regionally can provide those perspectives for countries where patients are not mobilised to participate.
