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Sociodemographic factors affect thyroid cancer survival rates in young adults
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Certain subgroups of adolescents and young adults with differentiated thyroid cancer may have a higher risk of poor outcomes, including men, black or Hispanic patients and uninsured or underinsured patients, according to research in Thyroid.
In a large population-based study of adolescents and young adults in California, researchers also linked low socioeconomic status with worse thyroid cancer survival rates in young adult men, who are 2.5 times more likely to die of the disease than young adult women. Blacks were six times more likely to die of the disease than whites, whereas Hispanics were three times more likely, according to researchers.
“Identifying these patient subgroups may help in developing more effective treatment decisions and tailored survivorship guidelines for the highest risk individuals,” the researchers wrote.
Theresa H.M. Keegan, PhD, a research scientist at the Cancer Prevention Institute of California in Fremont, California, and colleagues at other institutions analyzed data from 16,827 adolescents and young adults (aged 15 to 39 years; 83% female) from the California Cancer Registry who were diagnosed with differentiated thyroid cancer between 1988 and 2010. Researchers analyzed survival by sociodemographic and clinical factors using Cox proportional hazards regression.
Theresa H.M. Keegan
Of the 2.1% of young adults who died, 16.7% died from thyroid cancer and 21.4% died from a subsequent cancer, according to researchers.
After adjusting for sociodemographic characteristics, young adult men were more than twice as likely to die of thyroid cancer as women the same age (HR = 2.77; 95% CI, 1.62-4.72), as well as more than twice as likely as women to die of any cause after a diagnosis of thyroid cancer (HR = 2.68; 95% CI, 2.14-3.34).
Living in a low socioeconomic status neighborhood also was associated with worse thyroid cancer survival among young adult men (HR = 3.11; 95% CI, 1.28-7.56), but not young adult women.
In addition, patients aged 15 to 29 years had a higher survival rate than those diagnosed at age 30 years or older, according to researchers.
“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 non-metropolitan areas,” Keegan told Endocrine Today. “Such barriers may include lack of health insurance, financial burden of cancer treatment and care, and lengthy travel time to health care facilities.
“Further population-based studies of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to further understanding and reducing these disparities,” Keegan said. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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