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Study Finds Large Disparities in Survival Among Adolescents and Young Adults With Differentiated Thyroid Cancer

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Key Points

  • African American and Hispanic young adults with differentiated thyroid cancer were six times and three times more likely, respectively, to die of their cancer than Caucasians.
  • Residing in low-socioeconomic neighborhoods, insurance status, age, and gender were also contributing factors.
  • Barriers to obtaining high-quality treatment and follow-up care may contribute to poor outcomes for adolescents and young adults diagnosed with thyroid cancer.

A large, diverse study of 16,827 adolescents and young adults with differentiated thyroid cancer has found that African Americans and Hispanics were six times and three times more likely, respectively, to die of their cancer than Caucasians. Residing in low-socioeconomic neighborhoods, insurance status, age, and gender were also contributing factors. The study by Keegan et al is published in Thyroid.

Study Findings

Researchers from the Cancer Prevention Institute of California analyzed data obtained from the California Cancer Registry on 16,827 adolescents and young adults diagnosed with differentiated thyroid cancer between 1988 and 2010. Survival, through 2010, by sociodemographic and clinical factors was analyzed using Cox proportional hazards regression.

The researchers found that of the 2.1% of adolescents and young adults who died, 16.7% died of thyroid cancer and 21.4% died of a subsequent cancer. In multivariate analyses, older adolescents and young adults aged 35 to 39 (vs those aged 15–29), men (hazard ratio [HR] = 2.77, 95% confidence interval [CI] = 1.62–4.72), and those of African American or Hispanic race/ethnicity (vs non-Hispanic whites) had worse thyroid cancer–specific survival.

In addition, residing in low–socioeconomic status neighborhoods (HR = 3.11, 95% CI = 1.28–7.56) and nonmetropolitan areas (HR = 5.53, 95% CI = 2.07–14.78) was associated with worse thyroid cancer–specific survival among adolescents and young adult men but not women.

“The findings suggest that barriers to obtaining high-quality treatment and follow-up care may contribute to poor outcomes for adolescent and young adult thyroid cancer patients of low socioeconomic status, as well as young men who live in nonmetropolitan areas,” said Theresa H. M. Keegan, PhD, MS, Research Scientist at the Cancer Prevention Institute of California and lead author of the study, in a statement. “Such barriers may include lack of health insurance, financial burden of cancer treatment and care, and lengthy travel time to health-care facilities.”

Further studies of these factors as well as lifestyle factors, concluded the researchers, “are critical to reducing these disparities.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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