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Racial disparities in papillary thyroid microcarcinoma survival

Published online by Cambridge University Press:  05 December 2016

U C Megwalu*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, California, USA
A T Saini
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
*
Address for correspondence: Dr Uchechukwu C Megwalu, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA Fax: +1 650 725 8502 E-mail: [email protected]

Abstract

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Kilfoy, BA, Zheng, T, Holford, TR, Han, X, Ward, MH, Sjodin, A et al. International patterns and trends in thyroid cancer incidence, 1973–2002. Cancer Causes Control 2009;20:525–31CrossRefGoogle ScholarPubMed
2 Davies, L, Welch, HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295:2164–7Google Scholar
3 Davies, L, Welch, HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg 2014;140:317–22Google Scholar
4 Leenhardt, L, Grosclaude, P, Chérié-Challine, L; Thyroid Cancer Committee. Increased incidence of thyroid carcinoma in France: a true epidemic or thyroid nodule management effects? Report from the French Thyroid Cancer Committee. Thyroid 2004;14:1056–60CrossRefGoogle ScholarPubMed
5 Dean, DS, Hay, ID. Prognostic indicators in differentiated thyroid carcinoma. Cancer Control 2000;7:229–39Google Scholar
6 Shaha, AR. Implications of prognostic factors and risk groups in the management of differentiated thyroid cancer. Laryngoscope 2004;114:393402 CrossRefGoogle ScholarPubMed
7 Jonklaas, J, Nogueras-Gonzalez, G, Munsell, M, Litofsky, D, Ain, KB, Bigos, ST et al. ; National Thyroid Cancer Treatment Cooperative Study Group. The impact of age and gender on papillary thyroid cancer survival. J Clin Endocrinol Metab 2012;97:E878–87Google Scholar
8 Chen, AY, Halpern, M. Factors predictive of survival in advanced laryngeal cancer. Arch Otolaryngol Head Neck Surg 2007;133:1270–6CrossRefGoogle ScholarPubMed
9 Shavers, VL, Harlan, LC, Winn, D, Davis, WW. Racial/ethnic patterns of care for cancers of the oral cavity, pharynx, larynx, sinuses, and salivary glands. Cancer Metastasis Rev 2003;22:2538 Google Scholar
10 Olarte, LS, Megwalu, UC. The impact of demographic and socioeconomic factors on major salivary gland cancer survival. Otolaryngol Head Neck Surg 2014;150:991–8Google Scholar
11 de Graeff, A, de Leeuw, JR, Ros, WJ, Hordijk, GJ, Blijham, GH, Winnubst, JA. Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer. Eur J Cancer 2001;37:332–9Google Scholar
12 Harari, A, Li, N, Yeh, MW. Racial and socioeconomic disparities in presentation and outcomes of well-differentiated thyroid cancer. J Clin Endocrinol Metab 2014;99:133–41Google Scholar
13 Yu, XM, Wan, Y, Sippel, RS, Chen, H. Should all papillary thyroid microcarcinomas be aggressively treated? An analysis of 18,445 cases. Ann Surg 2011;254:653–60Google Scholar
14Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2011 Sub (1973–2009 varying) - Linked To County Attributes - Total U.S., 1969–2010 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2012, based on the November 2011 submissionGoogle Scholar
15 Moo-Young, TA, Panergo, J, Wang, CE, Patel, S, Duh, HY, Winchester, DJ et al. Variations in clinicopathologic characteristics of thyroid cancer among racial ethnic groups: analysis of a large public city hospital and the SEER database. Am J Surg 2013;206:632–40Google Scholar
16 Noureldine, SI, Abbas, A, Tufano, RP, Srivastav, S, Slakey, DP, Friedlander, P et al. The impact of surgical volume on racial disparity in thyroid and parathyroid surgery. Ann Surg Oncol 2014;21:2733–9Google Scholar
17 Murray, JE. Marital protection and marital selection: evidence from a historical-prospective sample of American men. Demography 2000;37:511–21Google Scholar
18 Manzoli, L, Villari, P, Pirone, GM, Boccia, A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med 2007;64:7794 Google Scholar
19 Rendall, MS, Weden, MM, Favreault, MM, Waldron, H. The protective effect of marriage for survival: a review and update. Demography 2011;48:481506 Google Scholar
20 Cooper, GS, Virnig, B, Klabunde, CN, Schussler, N, Freeman, J, Warren, JL. Use of SEER-Medicare data for measuring cancer surgery. Med Care 2002;40:IV-43–48Google Scholar