Persistence of Disparity in Thyroid Cancer Survival After Adjustments for Socioeconomic Status and Access
Thyroid cancer incidence has increased substantially in the past 4 decades, estimated at 3.5% annually. Incidence is highest in white patients, yet black patients have the worst survival. Racial/ethnic differences in presentation and outcomes are hypothesized to be a result of differences in access...
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| Vydáno v: | The American surgeon Ročník 88; číslo 7; s. 1484 |
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| Hlavní autoři: | , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
01.07.2022
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| Témata: | |
| ISSN: | 1555-9823, 1555-9823 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
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| Shrnutí: | Thyroid cancer incidence has increased substantially in the past 4 decades, estimated at 3.5% annually. Incidence is highest in white patients, yet black patients have the worst survival. Racial/ethnic differences in presentation and outcomes are hypothesized to be a result of differences in access to care. Analyses delineating the relative contribution of access to racial/ethnic survival disparities are scarce. We aimed to explore the association of delay in access to care and early/increased detection with racial/ethnic disparities in thyroid cancer survival.
The Surveillance, Epidemiology, and End Results (SEER) database was queried from 2007 to 2011 for patients with a first primary thyroid cancer diagnosis and up to 5 years of follow-up. Composite scores were generated from county-level variables to capture socioeconomic status and screening habits. Kaplan-Meier analysis and Cox proportional hazards models were utilized for survival analysis.
We identified 46,970 patients (67% white, 7% black, 15% Hispanic, 10% Asian or Pacific Islander, and 1% unknown/other). Compared to white patients, black, Hispanic, and Asian or Pacific Islander patients were more likely to present with distant disease (3% vs 5%, 5%, and 6%, respectively; P < .001). After adjusting for sex, age, stage, subtype, tumor size, surgery, radiation, socioeconomics, and screening habits, black patients were the only race/ethnicity found to have increased odds of 5-year mortality compared to white patients (24%, P < .001).
Thyroid cancer survival is worst for black patients regardless of socioeconomic status or screening habits. Racial/ethnic disparities in survival are not attributable to early detection alone. |
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| Bibliografie: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 1555-9823 1555-9823 |
| DOI: | 10.1177/00031348221082282 |