Rural-Urban Disparities in the Continuum of Thyroid Cancer Care: Analysis of 92,794 Cases
Authors' conclusion
Compared to their urban counterparts, rural and frontier patients with thyroid cancer present with later-stage disease and experience higher disease-specific mortality.
Study context
- Population
- Patients diagnosed with thyroid cancer (1999–2017), linked California Cancer Registry and California Office of Statewide Health Planning and Development databases; 70.6% women, mean age 50.0 years
- Participants
- 92,794 patients
- Exposure
- Rural and frontier vs urban residence
- Outcome
- Distant disease at diagnosis (cases per 1000 new cases)
- Follow-up
- Diagnosis
Methodological detailspopulation-based registry, linked databases, Cox and logistic regression with stepwise covariate adjustment
- Population-based registry
- Linked databases
- Cox and logistic regression with stepwise covariate adjustment
Main finding
As reported in the abstract
- Rural vs Urban: P < 0.01
- Frontier vs Urban: P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | |
|---|---|---|
| Lost to follow-upRuralvs Urban | 1.69 (1.54–1.85) | |
| Lost to follow-upFrontiervs Urban | 3.03 (1.89–5.26) | |
| Disease-specific mortalityRuralvs Urban | 1.18 (1.07–1.30) | |
| Disease-specific mortalityFrontiervs Urban | 1.92 (1.22–2.77) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Incidence of MTCRural vs Urban · 17.9 vs. 13.6 cases per 1000 | P < 0.01 |
| Incidence of MTCFrontier vs Urban · 31.0 vs. 13.6 per 1000 | P < 0.01 |
| Incidence of ATCFrontier vs Urban · 15.5 vs. 7.1 per 1000 | P < 0.01 |
Lost to follow-up
- Rural and frontier residence independently associated with being lost to follow-up
Original publication
Rural-Urban Disparities in the Continuum of Thyroid Cancer Care: Analysis of 92,794 Cases. Thyroid. Published 22 January 2024. doi:10.
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