Thyroid cancer is more likely to be detected incidentally on imaging in private hospital patients

Abstract Background The incidence of well-differentiated thyroid cancer (WDTC) is increasing. Patients with higher socioeconomic status (SES) have higher rates of WDTC, possibly due to increased imaging and overdiagnosis. We compared methods of WDTC diagnosis in patients treated at a public and an adjacent private university hospital. Materials and Methods Patients with WDTC at the two hospitals between 2004 and 2010 were included. Patients were categorized into having their WDTC discovered on physical exam or on unrelated imaging. Demographic and pathologic data was collected. T-test was used for quantitative variables and chi-squared test was used for categorical values. Binomial logistic regression was used to asses for confounding. Results Among 473 patients, 402 (85%) were from the university hospital and 71 (15%) were from the public hospital. Patients from the university hospital were older (mean age 49 vs. 44, p-value 0.02) and had a different racial composition compared to those from the public hospital. The patients at the public hospital had larger tumors (23mm vs 18mm, p-value 0.04). Patients from the university hospital were more likely to have WDTC detected by imaging than patients in the public hospital (46% vs. 28%, p-value