Stephanie L. Lee
WASHINGTON — The development of a comprehensive thyroid cancer registry in urban hospitals with racially, ethnically and socioeconomically diverse patients may aid in understanding risk factors for tumor persistence and recurrence in underserved populations, according to data presented at the 88th Annual Meeting of the American Thyroid Association.
“Previous studies suggest there are disparities in the initial thyroid cancer stage and outcome depending on race/ethnicity and lower socioeconomic status,” Stephanie L. Lee, MD, PhD, professor of medicine and director of the Thyroid Health Center, section of endocrinology, diabetes and nutrition at Boston Medical Center, and Endocrine Today Editorial Board Member, said in an interview. “It is controversial whether there is an independent impact of race/ethnicity and socioeconomic status on the extent of disease at diagnosis, response to therapy and increased mortality or whether it is related to access to care.”
To capture retrospective and individual patient data, Lee and colleagues created a comprehensive thyroid cancer registry (ThyroCARE), enrolling 1,208 patients with thyroid cancer who had been seen at Boston Medical Center between 2000 and May 2018 (78.3% women; mean age of women, 60.6 years; mean age of men, 56.7 years; 68.2% white; 10.2% black; 12.9% Hispanic; 6.8% Asian; 14.9% other; 31% foreign born). The registry resides in a browser-based Research Electronic Data Capture program and consists of 1,208 discrete data points related to patient management.
Of the 953 patients with pathology reports, researchers found that 67.9% had papillary thyroid carcinoma, 24% had follicular variant of papillary thyroid carcinoma, 3.2% had follicular thyroid carcinoma, 3.2% had Hurthle cell carcinoma and 1.8% had poorly differentiated carcinoma/anaplastic thyroid carcinoma. Nonwhite patients had less papillary thyroid carcinoma but more follicular variant of papillary thyroid carcinoma and Hurthle cell carcinoma than white patients.
Researchers also found that white patients used more alcohol than nonwhite patients (60.5% vs. 30.2%) and were more educated.
There was no difference found in the eighth edition of the American Joint Committee on Cancer (AJCC) clinical staging or rate of radioactive iodine treatment, but nonwhite patients presented with more ATA intermediate risk and less low-risk tumors than white patients.
Finally, race/ethnicity did not affect the average age of patients at diagnosis, according to the researchers.
“This [Boston Medical Center] single institution comprehensive thyroid cancer registry will continue to examine whether race/ethnicity and socioeconomic status influence the compliance to the ATA guidelines for the management, initial staging (AJCC 8th edition and ATA risk), response to therapy and mortality,” Lee said. – by Melissa J. Webb
Lee SL, et al. Poster 125. Presented at: 88th Annual Meeting of the American Thyroid Association; Oct. 3-7, 2018; Washington, D.C.
Disclosures: The authors report no relevant financial disclosures.