The American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress:
Regional Differences Affect Thyroid Cancer Diagnosis
The geographic location where a patient receives his or her thyroid cancer diagnosis can affect the stage of presentation diagnosed and the patient’s cancer-free survival. Researchers from the University of Arizona Cancer Center in Tucson identified 87,308 patients diagnosed with thyroid cancer between 1973 and 2008 using the Surveillance Epidemiology and End Results database. Marlon Guerrero, MD, and investigators analyzed patients from 4 regions of the United States: 54.9% of patients (n = 47,958) were from the West; 18.1% (n = 15,802) were from the East; 15.3% (n = 13,386) were from the Midwest; and 11.6% (n = 10,162) were from the South.1
Regions of the country were identified as follows:
- West: San Francisco-Oakland, New Mexico, Seattle, Utah, San José, Los Angeles, and other areas
- South: Louisiana, Kentucky, Atlanta, and rural Georgia
- East: New Jersey and Connecticut
- Midwest: Iowa and Detroit
Patients who lived and were diagnosed in the West had a higher risk of presenting with distant and regional metastases. Patients from the South had lower incidences of cancer-free survival than any other region analyzed. Additionally, black patients who lived in the South had lower cancer-free survival rates than black patients who lived in the West. The authors stratified the data by cancer subtype and race/ethnicity, and found no significant associations between geographic location and cancer-free survival rate. Across the board, 5.6% of patients presented with distant metastasis, 34% with regional metastasis, and 60% with localized disease. The most prevalent diagnosis across all ethnicities and regions was papillary thyroid cancer, followed by follicular thyroid cancer.
The authors speculated at the possible reason for different thyroid cancer stage diagnoses throughout the regions. “The reason for this is multifactorial, but differences in socioeconomic factors, access to health care, and cultural beliefs are contributing factors,” concluded the authors.