Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma

Research output: Contribution to journalArticle

Abstract

Background: Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non-aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior. Methods: Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004-2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC. Results: Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P <.001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28-1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82-0.99) (P <.001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86-0.92 and aOR = 0.81, 95% CI: 0.79-0.84) and higher odds of LNM and ETE than whites (P <.001). Conclusions: Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Hispanic Americans
Incidence
Lymph Nodes
Neoplasm Metastasis
Neoplasms
Logistic Models
Databases
Papillary Thyroid cancer
Therapeutics
Medical Overuse

Keywords

  • endocrine gland neoplasms
  • follicular variant
  • histologic variants
  • papillary thyroid cancer
  • thyroid cancer

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

@article{32f46e2f6b0a48cfb14acabb6b963360,
title = "Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma",
abstract = "Background: Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non-aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior. Methods: Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004-2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC. Results: Blacks had the highest fvPTC rate (40{\%} vs white 30{\%}, Hispanic 26{\%}, Asian 25{\%}, P <.001). Blacks had higher odds of fvPTC (aOR = 1.33, 95{\%} CI: 1.28-1.37) and lower odds of ETE than whites (aOR = 0.90, 95{\%} CI: 0.82-0.99) (P <.001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95{\%} CI: 0.86-0.92 and aOR = 0.81, 95{\%} CI: 0.79-0.84) and higher odds of LNM and ETE than whites (P <.001). Conclusions: Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.",
keywords = "endocrine gland neoplasms, follicular variant, histologic variants, papillary thyroid cancer, thyroid cancer",
author = "Vikas Mehta and Ow, {Thomas J.} and Seokhwa Kim and Theresa Tharakan and Schiff, {Bradley A.} and Smith, {Richard V.} and Haejin In",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/hed.25596",
language = "English (US)",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma

AU - Mehta, Vikas

AU - Ow, Thomas J.

AU - Kim, Seokhwa

AU - Tharakan, Theresa

AU - Schiff, Bradley A.

AU - Smith, Richard V.

AU - In, Haejin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non-aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior. Methods: Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004-2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC. Results: Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P <.001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28-1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82-0.99) (P <.001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86-0.92 and aOR = 0.81, 95% CI: 0.79-0.84) and higher odds of LNM and ETE than whites (P <.001). Conclusions: Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

AB - Background: Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non-aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior. Methods: Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004-2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC. Results: Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P <.001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28-1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82-0.99) (P <.001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86-0.92 and aOR = 0.81, 95% CI: 0.79-0.84) and higher odds of LNM and ETE than whites (P <.001). Conclusions: Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

KW - endocrine gland neoplasms

KW - follicular variant

KW - histologic variants

KW - papillary thyroid cancer

KW - thyroid cancer

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