Geographic disparities in thyroid cancer staging at presentation: Insights from an Australian context.

Autor: Yang ZM; Faculty of Medicine and Health Sciences and Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia., Tong CW; St George Hospital, Sydney, New South Wales, Australia., Bhimani N; Faculty of Medicine and Health Sciences and Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.; Faculty of Medicine, The Kinghorn Cancer Centre, Garvan Institute of Medical Research, St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia., O'Neill CJ; John Hunter Hospital and University of Newcastle, Newcastle, New South Wales, Australia., Lai CSL; Discipline of Surgery, University of Adelaide and The Queen Elizabeth Hospital, Adelaide, South Australia, Australia., Serpell JW; Endocrine Surgical Unit, The Alfred, Melbourne, Victoria, Australia., Glover AR; Faculty of Medicine and Health Sciences and Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.; Faculty of Medicine, The Kinghorn Cancer Centre, Garvan Institute of Medical Research, St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Jun; Vol. 48 (6), pp. 1440-1447. Date of Electronic Publication: 2024 May 11.
DOI: 10.1002/wjs.12211
Abstrakt: Background: Thyroid cancer diagnoses have increased over recent decades at a rate much higher than that of any other cancer in Australia. Rural patients are known to have reduced access to healthcare and may have different thyroid cancer presentation rates. This study examined the relationship between thyroid cancer diagnosis and patient rurality.
Methods: Data from the Australia and New Zealand Thyroid Cancer Registry from 2017 to 2022 were analyzed, stratifying patient postcodes into rurality groups using the Australian Statistical Geography Standard. The American Thyroid Association (ATA) guidelines were used to stratify risk categories and management to compare treatment adequacy between the groups. Statistical analysis assessed demographic, clinical, and management differences.
Results: Among 1766 patients, 70.6% were metropolitan (metro) and 29.4% were non-metropolitan (non-metro). Non-metro patients were older at diagnosis (median 56 vs. 50 years, p < 0.001), presented more frequently with T stage greater than 1 (stage 2-4, 41.9% vs. 34.8%, and p = 0.005), AJCC stage greater than 1 (stage 2-4, 18.5% vs. 14.6%, and p = 0.019), and cancers larger than 4 cm (14.3% vs. 9.9%, p = 0.005). No significant differences in treatment adequacy were observed between the groups for ATA low-risk cancers.
Conclusions: Non-metropolitan patients in the registry present with more advanced thyroid cancer, possibly due to differences in healthcare access. Further research should assess long-term survival outcomes and influencing factors. Understanding the impact on patient outcomes and addressing healthcare access barriers can optimize thyroid cancer care across geographic regions in Australia.
(© 2024 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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