Social Vulnerability Association with Thyroid Cancer Disparities in the United States
Authors' conclusion
Our results show significant detriments in thyroid cancer care and prognosis in the United States with increasing overall social vulnerability while identifying which SDoH quantifiably contribute more to disparities in inter-relational, real-world-like contexts.
Study context
- Population
- Adult thyroid cancer patients, 1975 to 2017, across all U.S. counties (SEER)
- Participants
- 199,340 patients
- Exposure
- Increasing overall social vulnerability
- Outcome
- Regression trends in months of follow-up/surveillance, survival, late staging and treatment receipt across thyroid cancer subtypes with increasing overall social vulnerability
Methodological detailsSEER database, CDC social vulnerability index, county-level
- SEER database
- CDC social vulnerability index
- County-level
Main finding
As reported in the abstract
Months of follow-up/surveillance with increasing overall social vulnerability
- Decreases in months of follow-up with papillary, follicular, medullary, oncocytic and anaplastic thyroid cancer
- p = 0.001
- Relative decrease in months of surveillance, lowest vs highest vulnerability, anaplastic
- 55.6% (14.5-6.5 months)
- Relative decrease in months of surveillance, lowest vs highest vulnerability, oncocytic
- 17% (108.6-90.2)
Observational data: associations, not effects.
Further findings
Survival decreases with increasing vulnerability
- Survival decrease, anaplastic
- 55.9% (9.6-4.2)
- Survival decrease, oncocytic
- 28.3% (97-69.5)
- Minority-language status and housing-transportation vulnerabilities largely contributed
Advanced staging and indicated treatment with increasing overall vulnerability
- Advanced staging, papillary: OR
- 1.07 (CI 1.03-1.12)
- Surgery, lowest (medullary): OR
- 0.91 (CI 0.84-0.99)
- Radiation therapy, lowest (anaplastic): OR
- 0.88 (CI 0.82-0.93)
- Chemotherapy, lowest (oncocytic): OR
- 0.81 (CI 0.67-0.98)
- Minority-language status and housing-transportation, followed by socioeconomic status vulnerabilities, were differential contributors
Original publication
Social Vulnerability Association with Thyroid Cancer Disparities in the United States. Thyroid. Published 9 December 2023. doi:10.
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