Disparities in Disease Severity at Presentation among Patients with Papillary Thyroid Cancer: A Retrospective Cohort Study

Purpose Prior research suggests that racial and ethnic minorities tend to present with more advanced papillary thyroid cancer (PTC). Traditionally, these studies have used pathologic staging from surgical specimen to characterize disease severity at presentation. It has become evident, however, that marginalized populations are also the most likely to experience delays in surgical treatment from initial presentation. The aim of the present study is to investigate if disparities in initial clinical presentation, defined using Fine Needle Aspiration (FNA) cytology, exist in our institutional cohort of patients with PTC. Methods A single-site retrospective review of 443 patients with PTC from 2018–2019 was performed. We investigated the association between several sociodemographic variables and the likelihood of presenting with malignancy on FNA using the Bethesda classification system. Results On multivariable analysis, young age and lower socioeconomic status (SES) were significant predictors of presenting with a cytologic diagnosis of malignant disease, while adjusting for race/ethnicity and insurance status. Conclusion Within our diverse patient cohort, differences in initial clinical presentation were observed. We identified SES and age as independent predictors of presenting with malignancy. These findings highlight specific patient factors that can help support providers with prompt diagnosis and effective management of PTC in high-risk patient cohorts.