Lower socioeconomic status is associated with more advanced thyroid cancer stage at presentation: a study in two Canadian centres

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 459-496-Thyroid Neoplasia & Case Reports
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-472
Stephanie Siu*1, Ted McDonald2, Murali Rajaraman3, Jason Franklin1, Terri Louise Paul1, Irina Rachinsky1, Deric James Morrison1, Syed Ali Imran3, Steven Burrell3, Robert Hart3, Albert Driedger1, Mahmoud Badreddine4, John Yoo1, Martin Corsten5 and Stan Van Uum6
1Schulich School of Medicine and Dentistry, Western University, London, ON, Canada, 2University of New Brunswick, Fredericton, NB, Canada, 3Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada, 4London Health Sciences Centre, London, ON, Canada, 5University of Ottawa, Ottawa, ON, Canada, 6Western University, London, ON, Canada
Introduction: Thyroid cancer is increasingly diagnosed in North America. Some studies have suggested a higher rate of thyroid cancer in patients with insurance coverage and higher socioeconomic status (SES). However, it is not known if the stage of thyroid cancer at presentation varies with SES in Canada.

Methods: We used data from the Canadian Thyroid Cancer Consortium, a large thyroid cancer registry that collects data from two major thyroid cancer referral centers (London, Ontario and Halifax, Nova Scotia). We included patients who presented with thyroid cancer between 1998 and 2011. We determined age at presentation, sex, and thyroid cancer status using the AJCC staging criteria. Individual’s postal codes were used to retrieve data from the Canadian Census for the years 1996, 2001 and 2006 to approximate household income. Logistic regression was used to determine odds ratios of presenting with advanced stage thyroid cancer as they relate to income, age, and sex.

Results: We included 1701 patients, 1334 cases from London and 367 from Halifax. Thyroid cancer was diagnosed more frequently in the higher SES groups (p<0.001). Compared to patients in the top income quintile, patients in the lowest and second lowest income quintiles had significantly higher odds of having more advanced stage thyroid cancer at presentation (OR 1.58, p=0.002; 1.37, p=0.024 respectively). Older age was associated with more advanced thyroid cancer (OR 1.02, p<0.001). Men were more likely than women to face higher stage thyroid cancer (OR 2.10, p<0.001).

Conclusion:  While thyroid cancers were diagnosed more frequently in patients of higher SES, patients in the lower SES groups had more advanced stage thyroid cancer at presentation. Our study indicates that health disparity exists in thyroid cancer in Canada.

Nothing to Disclose: SS, TM, MR, JF, TLP, IR, DJM, SAI, SB, RH, AD, MB, JY, MC, SV

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm