Sociodemographic disparities in differentiated thyroid cancer survival among adolescents and young adults in California

Theresa H Keegan, Raymon H. Grogan, Helen M. Parsons, Li Tao, Michael G. White, Kenan Onel, Pamela L. Horn-Ross

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Few studies have focused on prognostic factors among adolescents and young adults (AYAs) 15 to 39 years of age when diagnosed with differentiated thyroid cancer (DTC). Our study expands upon prior work by including an evaluation of survival among AYA men and by neighborhood socioeconomic status, health insurance, and clinical factors to identify subgroups of young DTC patients at higher risk of mortality. Methods: Data for 16,827 AYA DTC patients diagnosed between 1988 and 2010 were obtained from the California Cancer Registry. Survival, through 2010, by sociodemographic and clinical factors was analyzed using Cox proportional hazards regression. Results: Of the 2.1% of AYAs who died, 16.7% died from thyroid cancer and 21.4% died from a subsequent cancer. In multivariate analyses, older AYAs 35 to 39 year of age (versus 15-to 29-year-olds), men (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.62-4.72), and AYAs of African American or Hispanic race/ethnicity (versus non-Hispanic whites) had worse thyroid cancer specific survival. In addition, residing in low socioeconomic status neighborhoods (HR 3.11 [CI 1.28-7.56]) and nonmetropolitan areas (HR 5.53 [CI 2.07-14.78]) was associated with worse thyroid cancer-specific survival among AYA men, but not AYA women. Conclusions: Despite the generally good prognosis among AYAs with DTC, we identified subgroups of AYA patients at risk for poor outcomes. Further study of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to reducing these disparities.

Original languageEnglish (US)
Pages (from-to)635-648
Number of pages14
JournalThyroid
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Fingerprint

Thyroid Neoplasms
Young Adult
Survival
Confidence Intervals
Social Class
Aftercare
Health Insurance
Hispanic Americans
African Americans
Registries
Life Style
Neoplasms
Multivariate Analysis
Mortality

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Sociodemographic disparities in differentiated thyroid cancer survival among adolescents and young adults in California. / Keegan, Theresa H; Grogan, Raymon H.; Parsons, Helen M.; Tao, Li; White, Michael G.; Onel, Kenan; Horn-Ross, Pamela L.

In: Thyroid, Vol. 25, No. 6, 01.06.2015, p. 635-648.

Research output: Contribution to journalArticle

Keegan, Theresa H ; Grogan, Raymon H. ; Parsons, Helen M. ; Tao, Li ; White, Michael G. ; Onel, Kenan ; Horn-Ross, Pamela L. / Sociodemographic disparities in differentiated thyroid cancer survival among adolescents and young adults in California. In: Thyroid. 2015 ; Vol. 25, No. 6. pp. 635-648.
@article{817bf0e3278e497589f68f52248cb220,
title = "Sociodemographic disparities in differentiated thyroid cancer survival among adolescents and young adults in California",
abstract = "Background: Few studies have focused on prognostic factors among adolescents and young adults (AYAs) 15 to 39 years of age when diagnosed with differentiated thyroid cancer (DTC). Our study expands upon prior work by including an evaluation of survival among AYA men and by neighborhood socioeconomic status, health insurance, and clinical factors to identify subgroups of young DTC patients at higher risk of mortality. Methods: Data for 16,827 AYA DTC patients diagnosed between 1988 and 2010 were obtained from the California Cancer Registry. Survival, through 2010, by sociodemographic and clinical factors was analyzed using Cox proportional hazards regression. Results: Of the 2.1{\%} of AYAs who died, 16.7{\%} died from thyroid cancer and 21.4{\%} died from a subsequent cancer. In multivariate analyses, older AYAs 35 to 39 year of age (versus 15-to 29-year-olds), men (hazard ratio [HR] 2.77, 95{\%} confidence interval [CI] 1.62-4.72), and AYAs of African American or Hispanic race/ethnicity (versus non-Hispanic whites) had worse thyroid cancer specific survival. In addition, residing in low socioeconomic status neighborhoods (HR 3.11 [CI 1.28-7.56]) and nonmetropolitan areas (HR 5.53 [CI 2.07-14.78]) was associated with worse thyroid cancer-specific survival among AYA men, but not AYA women. Conclusions: Despite the generally good prognosis among AYAs with DTC, we identified subgroups of AYA patients at risk for poor outcomes. Further study of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to reducing these disparities.",
author = "Keegan, {Theresa H} and Grogan, {Raymon H.} and Parsons, {Helen M.} and Li Tao and White, {Michael G.} and Kenan Onel and Horn-Ross, {Pamela L.}",
year = "2015",
month = "6",
day = "1",
doi = "10.1089/thy.2015.0021",
language = "English (US)",
volume = "25",
pages = "635--648",
journal = "Thyroid",
issn = "1050-7256",
publisher = "Mary Ann Liebert Inc.",
number = "6",

}

TY - JOUR

T1 - Sociodemographic disparities in differentiated thyroid cancer survival among adolescents and young adults in California

AU - Keegan, Theresa H

AU - Grogan, Raymon H.

AU - Parsons, Helen M.

AU - Tao, Li

AU - White, Michael G.

AU - Onel, Kenan

AU - Horn-Ross, Pamela L.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background: Few studies have focused on prognostic factors among adolescents and young adults (AYAs) 15 to 39 years of age when diagnosed with differentiated thyroid cancer (DTC). Our study expands upon prior work by including an evaluation of survival among AYA men and by neighborhood socioeconomic status, health insurance, and clinical factors to identify subgroups of young DTC patients at higher risk of mortality. Methods: Data for 16,827 AYA DTC patients diagnosed between 1988 and 2010 were obtained from the California Cancer Registry. Survival, through 2010, by sociodemographic and clinical factors was analyzed using Cox proportional hazards regression. Results: Of the 2.1% of AYAs who died, 16.7% died from thyroid cancer and 21.4% died from a subsequent cancer. In multivariate analyses, older AYAs 35 to 39 year of age (versus 15-to 29-year-olds), men (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.62-4.72), and AYAs of African American or Hispanic race/ethnicity (versus non-Hispanic whites) had worse thyroid cancer specific survival. In addition, residing in low socioeconomic status neighborhoods (HR 3.11 [CI 1.28-7.56]) and nonmetropolitan areas (HR 5.53 [CI 2.07-14.78]) was associated with worse thyroid cancer-specific survival among AYA men, but not AYA women. Conclusions: Despite the generally good prognosis among AYAs with DTC, we identified subgroups of AYA patients at risk for poor outcomes. Further study of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to reducing these disparities.

AB - Background: Few studies have focused on prognostic factors among adolescents and young adults (AYAs) 15 to 39 years of age when diagnosed with differentiated thyroid cancer (DTC). Our study expands upon prior work by including an evaluation of survival among AYA men and by neighborhood socioeconomic status, health insurance, and clinical factors to identify subgroups of young DTC patients at higher risk of mortality. Methods: Data for 16,827 AYA DTC patients diagnosed between 1988 and 2010 were obtained from the California Cancer Registry. Survival, through 2010, by sociodemographic and clinical factors was analyzed using Cox proportional hazards regression. Results: Of the 2.1% of AYAs who died, 16.7% died from thyroid cancer and 21.4% died from a subsequent cancer. In multivariate analyses, older AYAs 35 to 39 year of age (versus 15-to 29-year-olds), men (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.62-4.72), and AYAs of African American or Hispanic race/ethnicity (versus non-Hispanic whites) had worse thyroid cancer specific survival. In addition, residing in low socioeconomic status neighborhoods (HR 3.11 [CI 1.28-7.56]) and nonmetropolitan areas (HR 5.53 [CI 2.07-14.78]) was associated with worse thyroid cancer-specific survival among AYA men, but not AYA women. Conclusions: Despite the generally good prognosis among AYAs with DTC, we identified subgroups of AYA patients at risk for poor outcomes. Further study of the factors underlying these associations, including possible barriers to receiving high-quality treatment and follow-up care, as well as lifestyle factors, are critical to reducing these disparities.

UR - http://www.scopus.com/inward/record.url?scp=84930520009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930520009&partnerID=8YFLogxK

U2 - 10.1089/thy.2015.0021

DO - 10.1089/thy.2015.0021

M3 - Article

C2 - 25778795

AN - SCOPUS:84930520009

VL - 25

SP - 635

EP - 648

JO - Thyroid

JF - Thyroid

SN - 1050-7256

IS - 6

ER -