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Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
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Pediatric thyroid cancer: Socioeconomic disparities and their impact on access to care

Heming H Zhao1, Scott M Wilhelm1

  • 1University Hospitals, Cleveland Medical Center, Cleveland, OH.

Surgery
|October 20, 2023
PubMed

Insights

Disparities exist in pediatric thyroid cancer care access and outcomes. Socioeconomic factors and race significantly impact treatment delays and survival for differentiated thyroid cancer patients.

Area of Science:

  • Pediatric Oncology
  • Health Services Research
  • Cancer Disparities

Background:

  • Limited research exists on healthcare access disparities for pediatric thyroid cancers.
  • Understanding socioeconomic and patient factors influencing care for pediatric differentiated thyroid cancer (DTC) and aggressive papillary thyroid cancer (PTC) variants is crucial.

Purpose of the Study:

  • To investigate socioeconomic and patient-related factors affecting access to care for pediatric differentiated thyroid cancer and aggressive papillary thyroid cancer variants.
  • To identify trends in access to care and outcomes over time.
  • To analyze racial/ethnic and socioeconomic disparities in treatment and survival.

Main Methods:

  • Retrospective analysis of the National Cancer Database (2004-2019) for pediatric DTC and aggressive PTC.
  • Patients categorized into three time periods (2004-2008, 2009-2013, 2014-2019) to assess temporal trends.
  • Statistical analyses (chi-squared, Kruskal-Wallis) used to evaluate socioeconomic and disease factors.

Main Results:

  • Analysis included 6,275 pediatric DTC patients and 182 with aggressive PTC.
  • Medicaid and lower-income DTC patients faced longer travel distances for care (2014-2019).
  • Racial/ethnic disparities observed: Black and Hispanic patients had higher odds of delayed surgery (>30 days). Black DTC patients showed increased mortality risk compared to White and Hispanic patients. Nodal positivity was higher in Hispanic DTC patients.
  • Socioeconomic factors did not significantly impact survival or nodal positivity in aggressive PTC variants.

Conclusions:

  • Significant disparities in access to care and survival outcomes exist for pediatric DTC and aggressive PTC.
  • Race, income, and insurance type are key determinants of these disparities.
  • Further research and targeted interventions are necessary to improve care access and patient outcomes.
Abstract

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