Thyroid cancer mortality is higher in Filipinos in the United States: An analysis using national mortality records from 2003 through 2012

BACKGROUND Well‐differentiated thyroid carcinoma has a favorable prognosis, but patients with multiple recurrences have drastically lower survival. Filipinos in the United States are known to have high rates of thyroid cancer incidence and disease recurrence. To the authors' knowledge, it is unknown whether Filipinos also have higher thyroid cancer mortality rates. METHODS The authors studied thyroid cancer mortality in Filipino, non‐Filipino Asian (NFA), and non‐Hispanic white (NHW) adults using US death records (2003‐2012) and US Census data. Age‐adjusted mortality rates and proportional mortality ratios (PMRs) were calculated. Sex, nativity status, age at death, and educational attainment also were examined. RESULTS The authors examined 19,940,952 deaths. The age‐adjusted mortality rates due to thyroid cancer were highest in Filipinos (1.72 deaths per 100,000 population; 95% confidence interval [95% CI], 1.51‐1.95) compared with NFAs (1.03 per 100,000 population; 95% CI, 0.95‐1.12) and NHWs (1.17 per 100,000 population; 95% CI, 1.16‐1.18). Compared with NHWs, higher proportionate mortality was observed in Filipino women (3‐5 times higher) across all age groups, and among Filipino men, the PMR was 2 to 3 times higher in the subgroup aged >55 years. Filipinos who completed a higher educational level had a notably higher PMR (5.0) compared with their counterparts who had not (3.5). CONCLUSIONS Negative prognostic factors for thyroid cancer traditionally include age >45 years and male sex. The results of the current study demonstrate that Filipinos die of thyroid cancer at higher rates than NFA and NHW individuals of similar ages. Highly educated Filipinos and Filipino women may be especially at risk of poor thyroid cancer outcomes. Filipino ethnicity should be factored into clinical decision making in the management of patients with thyroid cancer. Cancer 2017;123:4860‐7. © 2017 American Cancer Society. Identifying demographic indicators of poor prognosis in patients with thyroid cancer is vital for effective, personalized clinical decision making. After the analysis of approximately 19 million death records, the authors demonstrate that Filipinos die at a higher age‐adjusted rate and have higher proportionate mortality compared with non‐Filipino Asian and non‐Hispanic white individuals.