Head and Neck Cancers Coverage from Every Angle
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Racial Disparities in Follicular Variant of Papillary Thyroid Cancer

By: Joseph Fanelli
Posted: Wednesday, March 20, 2019

According to an analysis reported in Head & Neck, there appear to be racial differences within the follicular variant of papillary thyroid cancer in terms of incidence and behavior, with a higher incidence yet less aggressive disease noted in black patients compared with white patients. Vikas Mehta, MD, MPH, FACS, of the Montefiore Medical Center in the Bronx, and colleagues concluded that the findings provide compelling evidence for the incorporation of a patient’s race into the diagnosis and treatment of papillary thyroid cancer.

“These disparities could help guide preoperative decision-making and patient counseling by introducing the patient’s race as a possible predictive factor for [noninvasive follicular thyroid neoplasm with papillary-like nuclear features] vs. [follicular variant],” the authors commented. “These data are also relevant, as improved diagnostic approaches inform appropriate, less aggressive treatment strategies in select patients.”

The researchers analyzed 258,973 patients from the National Cancer Database diagnosed with papillary thyroid cancer. Among them, approximately 30% had a final histology of a follicular variant.

Dr. Mehta and colleagues reported that black patients had the highest rate of a follicular variant (40%), followed by white (30%), Hispanic (26%), and Asian (25%) patients. In addition, black patients had higher odds of a follicular variant (adjusted odds ratio = 1.33) than white patients as well as lower odds of extrathyroidal extension (adjusted odds ratio = 0.90). Hispanic and Asian patients had lower odds of a follicular variant (adjusted odds ratio = 0.89 and 0.81, respectively) and higher odds of lymph node metastasis than white patients (P < .001).

Disclosure: The study authors’ disclosure information may be found at wiley.com.

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