Photo Credit: Dr. Microbe
The following is a summary of “Racial implications of time to surgery in disparities in thyroid cancer survival,” published in the February 2024 issue of Surgery by Gillis et al.
The impact of time to surgery on racial and ethnic disparities in survival among patients with papillary thyroid carcinoma (PTC) warrants investigation yet remains largely unexplored. In this study, the study group interrogated the National Cancer Database from 2004 to 2017 to identify individuals diagnosed with localized PTC. Survival outcomes were meticulously compared across various time-to-surgery intervals, patient demographics, and comorbidities, with further analysis conducted through multivariable Cox regression modeling.
A striking demographic distribution emerged among the 126,708 patients included in their analysis, with 5% identified as Black and 10% as Hispanic. Notably, a significant disparity in median time to surgery was observed, with non-Hispanic White (NHW) patients undergoing surgery sooner than their Black and Hispanic counterparts (36 vs. 43 vs. 42 days, respectively; p < 0.001). Multivariable analysis unveiled a noteworthy association between delayed time to surgery (>90 days vs. <30 days) and worse survival outcomes (hazard ratio [HR]: 1.56, 95% CI: 1.43–1.70; p < 0.001). Additionally, when compared to NHW, the Black race was independently associated with poorer survival (HR: 1.21, 95% CI: 1.08–1.36; p = 0.001).
In essence, the findings underscore the harmful impact of surgical delay on thyroid cancer survival. However, even after accounting for time to surgery and other potential confounders, a persistent racial disparity in outcomes persists, with Black patients experiencing notably poorer survival rates. These findings illuminate the urgent need for targeted interventions aimed at mitigating healthcare disparities and ensuring equitable access to timely and effective treatment for all patients diagnosed with thyroid cancer.
Source: sciencedirect.com/science/article/abs/pii/S0002961024000631
