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 a...
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| Veröffentlicht in: | The Journal of surgical research 2017-07, Vol.215, p.239-244 |
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| creator | Zagzag, Jonathan, MD Kenigsberg, Alexander Patel, Kepal N., MD Heller, Keith S., MD Ogilvie, Jennifer B., MD |
| description | 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 |
| doi_str_mv | 10.1016/j.jss.2017.03.059 |
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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 <0.01) on univariate analysis. Conclusion This study demonstrates that patients with WDTC treated at a university hospital are more likely to have their tumor detected on unrelated imaging than those treated at a public hospital. These data may support the hypothesis that patients with improved insurance are more likely to have WDTC detected by imaging.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2017.03.059</identifier><identifier>PMID: 28688654</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Diagnosis ; Female ; Healthcare Disparities - statistics & numerical data ; Hospitals, Private ; Hospitals, Public ; Humans ; Imaging ; Incidental Findings ; Insurance Coverage - statistics & numerical data ; Insurance, Health - statistics & numerical data ; Logistic Models ; Male ; Medicaid ; Medical Overuse - statistics & numerical data ; Medicare ; Middle Aged ; New York ; Overdiagnosis ; Socioeconomic status ; Surgery ; Thyroid Neoplasms - diagnostic imaging ; United States ; Well-differentiated thyroid cancer</subject><ispartof>The Journal of surgical research, 2017-07, Vol.215, p.239-244</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-c2eda322bfb44ada7cc146388db2d212c7e89ca05b97e4eafa317870e54721593</citedby><cites>FETCH-LOGICAL-c408t-c2eda322bfb44ada7cc146388db2d212c7e89ca05b97e4eafa317870e54721593</cites><orcidid>0000-0001-6139-606X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022480417301907$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28688654$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zagzag, Jonathan, MD</creatorcontrib><creatorcontrib>Kenigsberg, Alexander</creatorcontrib><creatorcontrib>Patel, Kepal N., MD</creatorcontrib><creatorcontrib>Heller, Keith S., MD</creatorcontrib><creatorcontrib>Ogilvie, Jennifer B., MD</creatorcontrib><title>Thyroid cancer is more likely to be detected incidentally on imaging in private hospital patients</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>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 <0.01) on univariate analysis. Conclusion This study demonstrates that patients with WDTC treated at a university hospital are more likely to have their tumor detected on unrelated imaging than those treated at a public hospital. These data may support the hypothesis that patients with improved insurance are more likely to have WDTC detected by imaging.</description><subject>Adult</subject><subject>Aged</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Hospitals, Private</subject><subject>Hospitals, Public</subject><subject>Humans</subject><subject>Imaging</subject><subject>Incidental Findings</subject><subject>Insurance Coverage - statistics & numerical data</subject><subject>Insurance, Health - statistics & numerical data</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicaid</subject><subject>Medical Overuse - statistics & numerical data</subject><subject>Medicare</subject><subject>Middle Aged</subject><subject>New York</subject><subject>Overdiagnosis</subject><subject>Socioeconomic status</subject><subject>Surgery</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>United States</subject><subject>Well-differentiated thyroid cancer</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EotvCD-CCfOSSMP5IbAsJCVVAkSpxoJwtx55tnWbjxc5W2n9fhy0cOHCyxvPMK_sZQt4waBmw_v3YjqW0HJhqQbTQmWdkw8B0je6VeE42AJw3UoM8I-eljFBro8RLcsZ1r3XfyQ1xN3fHnGKg3s0eM42F7lJGOsV7nI50SXRAGnBBv2CgcfYx4Ly4qfbSTOPO3cb5tt7TfY4PbkF6l8o-VoDu3RIrWl6RF1s3FXz9dF6Qn18-31xeNdffv367_HTdeAl6aTzH4ATnw3aQ0gWnvGeyF1qHgQfOuFeojXfQDUahRLd1gimtADupOOuMuCDvTrn7nH4dsCx2F4vHaXIzpkOxzDDV99KYFWUn1OdUSsatra_fuXy0DOxq1o62mrWrWQvCwu_4t0_xh2GH4e_EH5UV-HACsH7yIWK2xVcBHkPM1Z4NKf43_uM_036Kc_RuuscjljEd8lztWWYLt2B_rKtdN8uUAGZAiUcUMp9a</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Zagzag, Jonathan, MD</creator><creator>Kenigsberg, Alexander</creator><creator>Patel, Kepal N., MD</creator><creator>Heller, Keith S., MD</creator><creator>Ogilvie, Jennifer B., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6139-606X</orcidid></search><sort><creationdate>20170701</creationdate><title>Thyroid cancer is more likely to be detected incidentally on imaging in private hospital patients</title><author>Zagzag, Jonathan, MD ; Kenigsberg, Alexander ; Patel, Kepal N., MD ; Heller, Keith S., MD ; Ogilvie, Jennifer B., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-c2eda322bfb44ada7cc146388db2d212c7e89ca05b97e4eafa317870e54721593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Diagnosis</topic><topic>Female</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Hospitals, Private</topic><topic>Hospitals, Public</topic><topic>Humans</topic><topic>Imaging</topic><topic>Incidental Findings</topic><topic>Insurance Coverage - statistics & numerical data</topic><topic>Insurance, Health - statistics & numerical data</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicaid</topic><topic>Medical Overuse - statistics & numerical data</topic><topic>Medicare</topic><topic>Middle Aged</topic><topic>New York</topic><topic>Overdiagnosis</topic><topic>Socioeconomic status</topic><topic>Surgery</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>United States</topic><topic>Well-differentiated thyroid cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zagzag, Jonathan, MD</creatorcontrib><creatorcontrib>Kenigsberg, Alexander</creatorcontrib><creatorcontrib>Patel, Kepal N., MD</creatorcontrib><creatorcontrib>Heller, Keith S., MD</creatorcontrib><creatorcontrib>Ogilvie, Jennifer B., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zagzag, Jonathan, MD</au><au>Kenigsberg, Alexander</au><au>Patel, Kepal N., MD</au><au>Heller, Keith S., MD</au><au>Ogilvie, Jennifer B., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thyroid cancer is more likely to be detected incidentally on imaging in private hospital patients</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>215</volume><spage>239</spage><epage>244</epage><pages>239-244</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>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 <0.01) on univariate analysis. Conclusion This study demonstrates that patients with WDTC treated at a university hospital are more likely to have their tumor detected on unrelated imaging than those treated at a public hospital. These data may support the hypothesis that patients with improved insurance are more likely to have WDTC detected by imaging.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28688654</pmid><doi>10.1016/j.jss.2017.03.059</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-6139-606X</orcidid></addata></record> |
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| subjects | Adult Aged Diagnosis Female Healthcare Disparities - statistics & numerical data Hospitals, Private Hospitals, Public Humans Imaging Incidental Findings Insurance Coverage - statistics & numerical data Insurance, Health - statistics & numerical data Logistic Models Male Medicaid Medical Overuse - statistics & numerical data Medicare Middle Aged New York Overdiagnosis Socioeconomic status Surgery Thyroid Neoplasms - diagnostic imaging United States Well-differentiated thyroid cancer |
| title | Thyroid cancer is more likely to be detected incidentally on imaging in private hospital patients |
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