O. Moaven1, R. Xie1, J. Richman1, D. Naftel1, J. K. Kirklin1, H. Chen1 1University Of Alabama at Birmingham,Department Of Surgery,Birmingham, Alabama, USA
Introduction: To improve the quality of care provided to the patients with thyroid cancer, we sought to examine and identify the trends and potential disparities in thyroid cancer diagnosis, various subtypes and patient demographics.
Methods: We assessed electronic medical records of the patients with the diagnostic codes for thyroid cancer in 2011-2016 at our institution. Patient demographics, specific type of cancer, insurance status, time to documented specific diagnosis and follow up visits were studied. Racial and gender disparities in the documented specific cancer diagnosis, time to specific diagnosis, and time to the first follow-up visit after the initial unspecific diagnosis were examined using univariate and multivariate cox regression modeling.
Results: There were 1640 patients with a documented diagnosis of thyroid cancer, and the cumulative incidence of thyroid cancer per 100,000 patients per year was highest in white females (60) followed by white males (42), black females (30), and black males (6, p<0.0001). After controlling for age, insurance type, and initial unspecific diagnosis year, white males had a higher likelihood of having a follow up clinic visit within 1 month after initial presentation (62% vs. 56%; HR: 1.19, p=0.01), as well as a documented designation with a specific diagnosis within 6 months (19% vs. 14%; HR: 1.45, p=0.01), when compared to those of white females. These differences were not significant when comparing whites vs. blacks.
Conclusion: There is a gender disparity, but no racial disparity, in a comprehensive workup and diagnosis of thyroid cancer within our health system. Identifying these inequalities is the first essential step in developing a health system that provides equal access to care.