Racial implications of time to surgery in disparities in thyroid cancer survival

Andrea Gillis; Polina Zmijewski; M Chandler Mcleod; Brenessa Lindeman; Jessica Fazendin; Herbert Chen; S Bhatia

doi:10.1016/j.amjsurg.2024.02.002

Racial implications of time to surgery in disparities in thyroid cancer survival

Am J Surg. 2024 Feb 27:S0002-9610(24)00063-1. doi: 10.1016/j.amjsurg.2024.02.002. Online ahead of print.

Authors

Andrea Gillis¹, Polina Zmijewski², M Chandler Mcleod², Brenessa Lindeman², Jessica Fazendin², Herbert Chen², S Bhatia³

Affiliations

¹ University of Alabama At Birmingham, Department of General Surgery, USA. Electronic address: agillis@uabmc.edu.
² University of Alabama At Birmingham, Department of General Surgery, USA.
³ University of Alabama At Birmingham, Department of General Pediatrics, USA.

PMID: 38519403
DOI: 10.1016/j.amjsurg.2024.02.002

Abstract

Introduction: The influence of time to surgery on racial/ethnic disparities in papillary thyroid carcinoma (PTC) survival remains unstudied.

Materials and methods: The National Cancer Database (2004-2017) was queried for patients with localized PTC. Survival data was compared by time to surgery, patient demographics, and multivariable Cox regression was performed.

Results: Of 126,708 patients included, 5% were Black, 10% Hispanic. Of all patients, 85% had no comorbidities. Non-Hispanic White (NHW) patients had a shorter median time to surgery than Black and Hispanic patients (36 vs. 43 vs. 42 days, respectively p < 0.001). In multivariable analysis, longer time to surgery (>90 days vs < 30 days) and Black race vs NHW, were associated with worse survival (HR: 1.56, (95%CI, 1.43-1.70), p < 0.001 and HR: 1.21, (1.08-1.36), p = 0.001), respectively.

Conclusion: Delaying surgery for thyroid cancer is associated with worse survival. However, independent of time to surgery and other confounders, there remains a disparity as black patients have poorer outcomes.

Keywords: Health outcomes disparities; Health services research; Papillary thyroid cancer; Race; Racial disparities; Thyroid cancer.