iodine deficiency leads to a range of health consequences commonly considered as iodine deficiency disorders ( idds ) ( 1 , 2 ) . idd is deemed as one of the major public health problems in many parts of the world ( 1 , 2 , 3 ) . in particular , thyroid nodular abnormalities ( or , goiter ) constitute one of the main idds . indeed , it is estimated that over 90% of the cases with goiter are caused by iodine deficiency conditions ( 4 , 5 ) . on the other hand , benign tumors of the thyroid gland ( alias , thyroid adenoma ) consist mainly of follicular adenomas , which are described as  cold  ,  warm  , or  hot  depending on their level of function ( 6 ) . benign thyroid disease is much more common in females ( 7 , 8) , and this fact has been suggested to lead to a higher rate of investigation and diagnosis of incidental papillary thyroid carcinoma ( 8) . it should be noted that the presence of benign thyroid nodules has been associated with an increased incidence of thyroid neoplasia ( 8) . nonetheless , there is no reported association between the presence of either hyperthyroid graves disease or autoimmune hypothyroidism and thyroid neoplasia ( 9 , 10 ) . the information about thyroid nodular abnormalities or benign tumors of the thyroid gland is scarce for transitional countries of the western balkans such albania and kosovo . as a matter of fact , to date , there are few scientific rigorous reports on this matter . in this framework , the aim of this study was to describe the demographic characteristics and disease patterns among patients with thyroid nodular abnormalities ( goiter ) and benign tumors of the thyroid gland in albania , a transitional country in south eastern europe . a cross - sectional study was conducted in albania covering the period 2004 - 2012 . all patients diagnosed with goiter and/or benign tumors of the thyroid gland who were hospitalized at the university hospital center  mother teresa  in tirana between 2004 and 2012 were included in this study . overall , for the period 2004 - 2012 ( inclusive ) there were 2204 hospitalized patients with the aforementioned diagnoses . binary logistic regression was used to compare the demographic characteristics between patients with benign tumors of the thyroid gland and those with thyroid nodular abnormalities ( goiter ) . unadjusted ( crude ) odds ratios ( ors ) , their respective 95% confidence intervals ( 95%cis ) and p - values were calculated . table 1 presents the distribution of demographic characteristics and disease patterns among patients with thyroid nodular abnormalities ( goiter ) . mean age in the overall sample of patients with goiter ( n=2204 ) was 46.412.6 years . females were somehow younger than males ( 46 years vs. 49 years , respectively ) . overall , 785 ( 35.6% ) of the patients were from tirana compared with 1419 ( 64.4% ) of the patients who were from other districts of albania . most of the patients ( about 59% ) were diagnosed during the period 2009 - 2012 . the mono - nodular goiter included 23% of the patients , the multi - nodular goiter 18% , whereas 59% of the patients exhibited other diagnoses of the thyroid gland . distribution of demographic characteristics and disease patterns among patients with thyroid nodular abnormalities ( goiter ) in albania , 2004 - 2012 . * mean values  standard deviations .  numbers and column percentages ( in parentheses ) . table 2 presents the distribution of demographic characteristics and disease patterns among patients with thyroid benign tumors . mean age in the overall sample of patients with benign tumors ( n=54 ) was 49.812.4 years . there were only 7 males ( 13% ) compared with 47 females ( 87% ) . overall , 21 ( 38.9% ) of the patients were from tirana compared with 33 ( 61.1% ) of the patients who were from other districts of albania . similar to the goiter , most of the patients with benign tumors ( about 61% ) were diagnosed over the period 2009 - 2012 . the toxic adenoma sinister included 39% of the patients with tumors , the toxic adenoma dexter included 44% , whereas 517% of the patients had other benign tumors of the thyroid gland . distribution of demographic characteristics and disease patterns among patients with thyroid benign tumors in albania , 2004 - 2012 . * mean values  standard deviations .  numbers and column percentages ( in parentheses ) . the comparison of demographic characteristics between patients with goiter and those with thyroid benign tumors is presented in table 3 . there was evidence of a borderline statistically significant difference between the two groups when age was treated as a numerical variable : patients with benign tumors were older than those with goiter ( or=1.02 , 95%ci=0.99 - 1.05 , p=0.093 ) . however , there was no evidence of a statistically significant difference between the two groups of the patients when age was introduced into the logistic models as a categorical term ( overall p=0.392 ) . furthermore , there were no significant gender differences ( or=0.53 , 95%ci=0.16 - 1.75 , p-0.299 ) . similarly , there were no significant differences in the place of residence between patients with benign tumors and those with goiter ( or=0.97 , 95%ci=0.46 - 1.39 , p=0.53 ) . comparison of demographic characteristics between patients with thyroid benign tumors and patients with thyroid nodular abnormalities ( goiter ) . * odds ratios ( ors ) : thyroid benign tumors vs. thyroid nodular abnormalities ( goiter ) .  overall p - value and degrees of freedom ( in parentheses ) . our study informs about the epidemiology of goiter and benign tumors of the thyroid gland in albania , a post - communist country in the western balkans . overall , there were no statistically significant differences in the distribution of demographic characteristics ( age , gender and place of residence ) between patients with benign tumors of the thyroid gland and those with thyroid nodular abnormalities ( goiter ) . as shown previously , many regions of albania are currently in a transition phase from iodine deficiency to iodine sufficiency ( 11 , 12 ) . nevertheless , in order to achieve a successful elimination of idd in albania , there is a need to enlarge and expand all the activities for ensuring a sustainable consumption of intensified awareness activities at a population level and an appropriate monitoring and evaluation system , similar to the recommendations pertinent to other countries ( 3 ) . we included in our analysis all the hospitalized cases with goiter or benign tumors of the thyroid gland from 2004 to 2012 . our study population had a reasonable size and represented all the cases with these conditions in the albanian population . therefore , on the face of it , there was no evidence of selection bias in our study population . furthermore , the diagnosis criteria of goiter or benign tumors of the thyroid gland were stable over time . in addition , there seems to be no reason for differential recording of the demographic characteristics of our study participants for the entire period under investigation . our study provides useful evidence on the epidemiology of benign tumors of the thyroid gland and the thyroid nodular abnormalities ( goiter ) in the albanian population  an under - researched country which is in the midst of a rapid process of political and socioeconomic transition . future studies in albania should assess the main determinants of thyroid gland disorders and compare them with findings pertinent to other similar populations .
aim : the aim of this study was to describe the demographic characteristics and disease patterns among patients with thyroid nodular abnormalities ( goiter ) and benign tumors of the thyroid gland in albania , a transitional country in south eastern europe.methods:our study included all patients diagnosed with goiter and/or benign tumors of the thyroid gland who were hospitalized at the university hospital center ( uhc )  mother teresa  in tirana between 2004 and 2012 ( n=2258 ) . 
 all patients underwent the same examination and interviewing procedures . 
 demographic characteristics included gender , age , and place of residence . 
 binary logistic regression was used to compare the demographic characteristics between patients with benign tumors of the thyroid gland and those with goiter.results:overall , there were 2204 patients with goiter and 54 patients with benign tumors of the thyroid gland hospitalized at uhc over the period 2004 - 2012 . 
 there was no evidence of statistically significant differences in demographic characteristics ( age , gender , or place of residence ) between patients with benign tumors of the thyroid gland and those with goiter.conclusions:our study provides useful evidence on the epidemiology of benign tumors of the thyroid gland and the thyroid nodular abnormalities ( goiter ) in the albanian population . 
 future studies in albania should assess the main determinants of thyroid gland disorders and compare them with findings pertinent to other similar populations .