Disparities in Initial Thyroid Cancer Care by Hospital Treatment Volume: Analysis of 52,599 Cases in California
Authors' conclusion
Patients receiving thyroid cancer surgery at centers performing ≤5 such operations per year were more likely to require reoperation for recurrent/persistent disease and less likely to receive appropriate 131I ablation. Ultra-low volume centers served higher proportions of socially and economically marginalized communities.
Study context
- Population
- Thyroid cancer patients who received thyroid surgery in California, 1999–2017
- Participants
- 52,599 patients
- Exposure
- Thyroid cancer surgery at ultra-low vs low-, mid- and high-volume hospitals
- Outcome
- Reoperation for recurrent/persistent disease
Methodological detailspopulation-based, linked California Cancer Registry and OSHPD databases, multivariable regression
- Population-based
- Linked California Cancer Registry and OSHPD databases
- Multivariable regression
Main finding
As reported in the abstract
Odds ratio (CI)
Ultra-low volumevs Low-volume
1.17(1.02–1.35)
Ultra-low volumevs Mid-volume
1.25(1.06–1.46)
Ultra-low volumevs High-volume
1.26(1.03–1.56)
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | |
|---|---|---|
| Guideline-concordant 131I ablationUltra-low volumevs Higher volume centers | 0.77 (0.72–0.82) | |
| 0.512Odds ratio (log scale) |
Outcomes among low-, mid- and high-volume centers
- No statistically significant differences between low-, mid- or high-volume centers; only ultra-low volume centers had significantly higher rates of adverse outcomes
Access to ultra-low vs higher volume centers by demographics
- Disproportionately accessed by women
- P < 0.05
- Disproportionately accessed by Hispanic, Asian/Pacific Islander and American Indian people
- P < 0.01
- Disproportionately accessed by lowest three socio-economic quintiles
- P < 0.01
- Disproportionately accessed by uninsured and Medicaid or Medicare
- P < 0.01
Original publication
Disparities in Initial Thyroid Cancer Care by Hospital Treatment Volume: Analysis of 52,599 Cases in California. Thyroid. Published 4 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →