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

Keegan, Theresa H.M.; Grogan, Raymon H.; Parsons, Helen; Li, Tao; White, Michael G.; Onel, Kenan; Horn‐Ross, Pamela L.

doi:10.1089/thy.2015.0021

Cited by 58 publications

(51 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Categories for age at diagnosis (15–24, 25–34, and 35–39) utilize similar cut-points as standard reporting by cancer registries and optimize the distribution of cases among categories. Vital status is routinely determined by the CCR through hospital follow-up [8, 9] and database linkages.…”

Section: Methodsmentioning

confidence: 99%

“…There is evidence that racial/ethnic disparities in cancer survival for some cancer sites may be mediated by access to health care or neighborhood SES [7, 8, 10]. It is well-documented that, compared to non-Hispanic White AYAs, Hispanic and Black AYAs are more likely to reside in lower SES neighborhoods [10] and are more likely to be uninsured or have public insurance [11, 12].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, each of these sociodemographic factors (i.e., minority race/ethnicity, lower neighborhood SES, and public or no insurance at diagnosis) have been associated with later-stage at diagnosis [11–13], undertreatment [7, 11], and greater risk of death among AYAs [7–11, 13, 14]. The few studies that have considered the independent associations of all three factors with cancer survival suggest that these associations remain in multivariable analyses, but differences exist by cancer site [8–10, 14]. Of note, however, no studies have considered the joint relationship of race/ethnicity, neighborhood SES, and health insurance type with survival among AYAs.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status

DeRouen

Parsons

Kent

et al. 2017

Cancer Causes Control

Self Cite

View full text Add to dashboard Cite

Purpose To investigate associations of sociodemographic factors—race/ethnicity, neighborhood socioeconomic status (SES), and health insurance—with survival for adolescent and young adults (AYAs) with invasive cancer. Methods Data on 80,855 AYAs with invasive cancer diagnosed in California 2001–2011 were obtained from the California Cancer Registry. We used multivariable Cox proportional hazards regression to estimate overall survival. Results Associations of public or no insurance with greater risk of death were observed for 11 of 12 AYA cancers examined. Compared to Whites, Blacks experienced greater risk of death, regardless of age or insurance, while greater risk of death among Hispanics and Asians was more apparent for younger AYAs and for those with private/military insurance. More pronounced neighborhood SES disparities in survival were observed among AYAs with private/military insurance, especially among younger AYAs. Conclusions Lacking or having public insurance was consistently associated with higher morality, while disparities according to race/ethnicity and neighborhood SES were greater among AYAs with private/military insurance. While health insurance coverage associates with survival, remaining racial/ethnic and socioeconomic disparities among AYAs with cancer suggest social factors also need consideration in intervention and policy development.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status

DeRouen

Parsons

Kent

et al. 2017

Cancer Causes Control

Self Cite

View full text Add to dashboard Cite

show abstract

“…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). Although the underlying cause of these racial and SES disparities are unknown, the etiology is thought to include differences in exposures and access to medical care (5).…”

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

View full text Add to dashboard Cite

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.

show abstract

“…As higher SES has been associated with improved thyroid cancer-specific outcomes, even in countries with universal healthcare, it is possible that RE+ DTC patients were of higher SES than DTC-patients (19,20). As males of low SES often have less access to healthcare and seek out healthcare less frequently than other groups of individuals, it may be that the finding that RE-males with DTC have worse outcomes than other groups is a reflection of disparities in healthcare rather than of biology (20).…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Differentiated Thyroid Cancer Is Associated with Improved Overall Survival but Not Thyroid Cancer–Specific Mortality or Disease-Free Survival

White

Abdulrasool

Kaplan

et al. 2016

Thyroid

Self Cite

View full text Add to dashboard Cite

Background: Radiation is a well-described risk factor for differentiated thyroid carcinoma (DTC). Although the natural history of DTC following nuclear disasters and in healthcare workers with chronic radiation exposure (RE) has been described, little is known about DTC following short-term exposure to therapeutic medical radiation for benign disease. This study compares DTC morphology and outcomes in patients with and without a prior history of therapeutic external RE. Methods: A retrospective review was performed of patients with DTC treated at The University of Chicago between 1951 and 1987, with a median follow-up of 27 years (range 0.3-60 years). Patients were classified as either having (RE+) or not having (RE-) a history of therapeutic RE. Variables examined included sex, age at RE, dose of RE, indication for RE, DTC histology, and outcome. Morphology was determined by blinded retrospective review of all available histologic slides. Outcomes were assessed using Cox proportional hazards model and Kaplan-Meier curves. Results: Of 257 DTC patients, 165 (64%) were RE-and 92 (36%) were RE+, with males comprising a greater proportion of the RE+ group (43.5% vs. 27.3%; p = 0.01). A total of 94.2% of DTC cases were classic papillary cancers; histology did not differ between RE+ and RE-cohorts ( p = 0.73). RE was associated with an increased median overall survival (OS; 43 years vs. Conclusions: While DTC following RE has historically been considered a more aggressive variant than DTC in the absence of RE, the present data indicate that RE+ DTC is associated with better OS than RE-DTC, especially for males. Additionally, recent reports are confirmed of equivalent rates of thyroid cancer recurrence. These results warrant further investigation into the factors underlying this unexpected finding.

show abstract

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

Cited by 58 publications

References 37 publications

Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status

Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status

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

Radiation-Induced Differentiated Thyroid Cancer Is Associated with Improved Overall Survival but Not Thyroid Cancer–Specific Mortality or Disease-Free Survival

Contact Info

Product

Resources

About