Racial/ethnic disparities in thyroid cancer in California, 1999–2017

• Published in: The American journal of surgery Vol. 225; no. 2; pp. 298 - 303
• Main Authors: Luff, Marie K., Kim, Jiyoon, Tseng, Chi-Hong, Livhits, Masha J., Yeh, Michael W., Wu, James X.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2023; Elsevier Limited
• Subjects: Age; Black or African American; California - epidemiology; California cancer registry; Cancer; Comorbidity; Disease; Health insurance; Health planning; Health services; Health Status Disparities; Healthcare Disparities; Hispanic Americans; Humans; Inequality; Insurance; Iodine; Iodine Radioisotopes; Lymphatic system; Medicaid; Medicare; Minority & ethnic groups; Mortality; Patients; Population; Race; Racial differences; Racial disparities; Registries; Reoperation; Sensitivity analysis; Socioeconomic factors; Survival; Thoracic surgery; Thyroid; Thyroid cancer; Thyroid Neoplasms - surgery; Thyroidectomy; Tumors; Uninsured people; United States; White; United States; California; United States > US; Reoperation; Thyroid cancer; Racial disparities; California cancer registry
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.09.041

Recent studies examining treatment disparities in thyroid cancer care found that appropriate use of surgery and radioactive iodine may be improving over time. California Cancer Registry and California Office of Statewide Health Planning and Development data was evaluated for the effect of race on overall and disease-specific survival for thyroid cancer in California (1999–2017). Reoperation data was also examined. We hypothesized treatment and outcome disparities would persist between Black and white patients. Black patients with thyroid cancer had worse overall survival than white patients (p < 0.01). No difference was found in disease-specific survival between Black and white patients after adjusting for SES and health insurance status. Black patients underwent reoperation less frequently (1.4%) (HR = 0.70 [CI, 0.50–0.99], p < 0.05) than white patients (2.0%). SES and insurance type are drivers of disparities in thyroid cancer survival in Black patients. Addressing social determinants of health or healthcare access are paramount to addressing disparities in thyroid cancer between Black and white patients. •Black patients with thyroid cancer had worse overall survival than white patients.•Black patients had worse disease-specific survival than white patients.•Socioeconomic and insurance status drive disparities in thyroid cancer survival.