Racial and Socioeconomic Disparities in Presentation and Outcomes of Well-Differentiated Thyroid Cancer

Harari, Avital; Li, Ning; Yeh, Michael W.

doi:10.1210/jc.2013-2781

Cited by 122 publications

(114 citation statements)

References 31 publications

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“…Many, but not all (17), studies have found poorer survival in men with DTC (9,10,18,19). While a previous study concluded that the apparent survival disadvantage among men overall resulted from a larger percentage of men diagnosed with advanced stage disease, in young men there was a small, statistically significant survival disadvantage for stage 1 papillary thyroid cancer and suggestive survival disadvantage in stage 2 papillary thyroid cancer (18).…”

Section: Discussionmentioning

confidence: 98%

Sociodemographic Disparities in Differentiated Thyroid Cancer Survival Among Adolescents and Young Adults in California

Keegan

Grogan

Parsons

et al. 2015

Thyroid

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Background: Few studies have focused on prognostic factors among adolescents and young adults (AYAs) 15 to 39 years of age when diagnosed with differentiated thyroid cancer (DTC). Our study expands upon prior work by including an evaluation of survival among AYA men and by neighborhood socioeconomic status, health insurance, and clinical factors to identify subgroups of young DTC patients at higher risk of mortality. Conclusions: Despite the generally good prognosis among AYAs with DTC, we identified subgroups of AYA patients at risk for poor outcomes. Further study of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to reducing these disparities.

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Section: Discussionmentioning

confidence: 98%

Sociodemographic Disparities in Differentiated Thyroid Cancer Survival Among Adolescents and Young Adults in California

Keegan

Grogan

Parsons

et al. 2015

Thyroid

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“…The results of this study show that race has an impact on survival in patients with papillary thyroid 12 Their study included 25 945 patients from the California Cancer Registry diagnosed with thyroid cancer from 1999 to 2008. They found that racial minority groups and patients with low socioeconomic status had a higher likelihood of presenting with metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

“…Another study found that racial minority groups and patients with low socioeconomic status had a higher likelihood of presenting with metastatic disease, and had an increased risk of mortality. 12 Yu et al evaluated risk factors for mortality in patients with papillary thyroid microcarcinoma. 13 They found that African American or minority race was associated with an increased risk of mortality.…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in papillary thyroid microcarcinoma survival

Megwalu

Saini

2016

J. Laryngol. Otol.

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Objective: To evaluate the impact of race on survival in patients with papillary thyroid microcarcinoma.Methods: The study cohort included 17 668 patients diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.Results: Black patients had lower overall survival than other racial groups ( p < 0.001). Black patients had significantly worse overall survival (hazard ratio = 2.59) after adjusting for sex, marital status, age, year of diagnosis, multifocal disease and type of surgery. A subset analysis of Black patients revealed no significant difference in overall survival for total thyroidectomy versus lobectomy ( p = 0.15).Conclusion: Black race is a negative prognostic factor in thyroid cancer, which cannot be explained by advanced disease stage. Further research on mechanisms by which race affects survival is needed to reveal areas of opportunity for interventions aimed at reducing health disparities in cancer care.

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“…Harari and colleagues have published that Black patients and those with a low socioeconomic status (SES) have worse outcomes for differentiated thyroid cancers than their White and higher SES counterparts (3). Similarly, Keegan et al recently published that adolescents and young adult patients residing in low SES neighborhoods and nonmetropolitan areas had worse thyroid cancer-specific survival among adolescent and young adult men (4).…”

Section: Introductionmentioning

confidence: 99%

Are there disparities in the presentation, treatment and outcomes of patients diagnosed with medullary thyroid cancer?—An analysis of 634 patients from the California Cancer Registry

et al. 2016

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Background: Race, gender and socioeconomic disparities have been suggested to adversely influence stage at presentation, treatment options and outcomes in patients with cancer. Underserved minorities and those with a low socioeconomic status (SES) present with more advanced disease and have worse outcomes for differentiated thyroid cancer, but this relationship has never been evaluated for medullary thyroid cancer (MTC). Methods:We used the California Cancer Registry (CCR) to evaluate disparities in the presentation, treatment and outcomes of patients diagnosed with MTC. Results:We identified 634 patients with MTC diagnosed between 1988 and 2011. Almost everyone (85%) underwent thyroidectomy with 50% having a central lymph node dissection (CLND). There were no statistically significant differences by age, race or SES in mean tumor size or the proportion of patients diagnosed with localized disease, but men were diagnosed with larger tumors than women and were less likely to be diagnosed at a localized stage. Younger patients and women were more likely to be treated with a thyroidectomy. There were no statistically significant differences in surgical treatment by race or SES.Patients in the highest SES category had a better overall survival, but not disease specific survival, than those in the lowest SES (HR =0.3, CI =0.1-0.7). Patients treated with thyroidectomy had a better overall and cause specific survival, but the effect of CLND was not statistically significant after adjustment for other factors.Conclusions: In MTC, we did not find that race, gender or SES influenced the presentation, treatment or outcomes of patients with MTC. Men with MTC present with larger tumors and are less likely to have localized disease. Half of the MTC patients in California do not undergo a CLND at the time of thyroidectomy, which may suggest a lack appropriate care across a range of healthcare systems.

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Racial and Socioeconomic Disparities in Presentation and Outcomes of Well-Differentiated Thyroid Cancer

Abstract: Black patients and those with low SES have worse outcomes for thyroid cancer. API and Hispanic patients may have a protective effect on survival despite presenting with more advanced disease.

Cited by 122 publications

References 31 publications

Sociodemographic Disparities in Differentiated Thyroid Cancer Survival Among Adolescents and Young Adults in California

Sociodemographic Disparities in Differentiated Thyroid Cancer Survival Among Adolescents and Young Adults in California

Racial disparities in papillary thyroid microcarcinoma survival

Are there disparities in the presentation, treatment and outcomes of patients diagnosed with medullary thyroid cancer?—An analysis of 634 patients from the California Cancer Registry

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