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National Cancer Database Reveals Disparities in Access to Thyroid Cancer Surgery

CHICAGO, In a study released earlier this year from the National Cancer Database (NCDB), the removal of the entire thyroid -- total thyroidectomy -- was shown to reduce papillary thyroid cancer recurrence rates and improve survival in patients whose tumors are larger than 1.0 cm. With that knowledge, researchers from the American College of Surgeons (ACS) wanted to determine if this surgical procedure is best for all thyroid cancer patients, and if all patients have equal access to this treatment.

This latest study, released today, found that Medicare recipients, the uninsured, and African-Americans, among others, were less likely to receive optimal treatment. The NCDB is a nationwide oncology outcomes database maintained by the Commission on Cancer of the ACS for more than 1,400 Commission-approved cancer programs in the United States and Puerto Rico.

"Cancer specialists agree that large tumors merit removal of the entire thyroid gland. But, historically, the surgical management of papillary tumors-those that are smaller than 4.0 cm, and specifically, less than 2.0 cm, has been one of the great debates in surgery," according to Karl Bilimoria, MD, NCDB Research Fellow, American College of Surgeons and a general surgery resident at Northwestern University's Feinberg School of Medicine, Chicago, IL.

In the second phase of the largest study of papillary thyroid cancer ever conducted, lead researcher Dr. Bilimoria and ACS colleagues found that not all papillary thyroid cancer patients (PTC) have equal access to optimal treatment. "We discovered significant patient factors associated with the likelihood of undergoing a total thyroidectomy," Dr. Bilimoria reported. "We've seen these factors in other cancer sites, but this is the first time they have been identified for thyroid cancer."

Patients were less likely to undergo a total thyroidectomy if they were African-American, older than 45 years, were Medicare recipi
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