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

Summary 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 relationshi...

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Veröffentlicht in:World journal of surgery 2024-06, Vol.48 (6), p.1440-1447
Hauptverfasser: Yang, Zihao M., Tong, Chai W., Bhimani, Nazim, O’Neill, Christine J., Lai, Christine S. L., Serpell, Jonathan W., Glover, Anthony R.
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container_end_page 1447
container_issue 6
container_start_page 1440
container_title World journal of surgery
container_volume 48
creator Yang, Zihao M.
Tong, Chai W.
Bhimani, Nazim
O’Neill, Christine J.
Lai, Christine S. L.
Serpell, Jonathan W.
Glover, Anthony R.
description Summary 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 
doi_str_mv 10.1002/wjs.12211
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L. ; Serpell, Jonathan W. ; Glover, Anthony R.</creator><creatorcontrib>Yang, Zihao M. ; Tong, Chai W. ; Bhimani, Nazim ; O’Neill, Christine J. ; Lai, Christine S. L. ; Serpell, Jonathan W. ; Glover, Anthony R.</creatorcontrib><description>Summary 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 &lt; 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.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1002/wjs.12211</identifier><identifier>PMID: 38733313</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Australia ; endocrine ; Female ; Health Services Accessibility - statistics &amp; numerical data ; Healthcare Disparities - statistics &amp; numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; New Zealand - epidemiology ; oncology ; Registries ; rural ; Rural Population - statistics &amp; numerical data ; Thyroid Neoplasms - diagnosis ; Thyroid Neoplasms - mortality ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - therapy</subject><ispartof>World journal of surgery, 2024-06, Vol.48 (6), p.1440-1447</ispartof><rights>2024 The Authors. World Journal of Surgery published by John Wiley &amp; Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3201-f07897270421f589fce10dd8ced1af3475e52975b22228627b94794b1ffcdfda3</cites><orcidid>0009-0001-8864-9757</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fwjs.12211$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fwjs.12211$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38733313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Zihao M.</creatorcontrib><creatorcontrib>Tong, Chai W.</creatorcontrib><creatorcontrib>Bhimani, Nazim</creatorcontrib><creatorcontrib>O’Neill, Christine J.</creatorcontrib><creatorcontrib>Lai, Christine S. L.</creatorcontrib><creatorcontrib>Serpell, Jonathan W.</creatorcontrib><creatorcontrib>Glover, Anthony R.</creatorcontrib><title>Geographic disparities in thyroid cancer staging at presentation: Insights from an Australian context</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><description>Summary 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 &lt; 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Australia</subject><subject>endocrine</subject><subject>Female</subject><subject>Health Services Accessibility - statistics &amp; numerical data</subject><subject>Healthcare Disparities - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>New Zealand - epidemiology</subject><subject>oncology</subject><subject>Registries</subject><subject>rural</subject><subject>Rural Population - statistics &amp; numerical data</subject><subject>Thyroid Neoplasms - diagnosis</subject><subject>Thyroid Neoplasms - mortality</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - therapy</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kD1PwzAQQC0EoqUw8AeQRxjS-iOJE7aqggKqxACIMXKdc-sqdYLtqPTfE0hh45Y7nZ7e8BC6pGRMCWGT3caPKWOUHqEhjTmLGGf8GA0JT-PupnyAzrzfEEJFStJTNOCZ4Lz7DxHMoV452ayNwqXxjXQmGPDYWBzWe1ebEitpFTjsg1wZu8Iy4MaBBxtkMLW9xY_Wm9U6eKxdvcXS4mnrg5OV6U5V2wCf4RydaFl5uDjsEXq7v3udPUSL5_njbLqIFGeERpqILBdMkJhRnWS5VkBJWWYKSio1j0UCCctFsmTdZCkTyzwWebykWqtSl5KP0HXvbVz90YIPxdZ4BVUlLdStLzhJeJ7mOUs79KZHlau9d6CLxpmtdPuCkuK7atFVLX6qduzVQdsut1D-kb8ZO2DSAztTwf5_U_H-9NIrvwAmXoJF</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Yang, Zihao M.</creator><creator>Tong, Chai W.</creator><creator>Bhimani, Nazim</creator><creator>O’Neill, Christine J.</creator><creator>Lai, Christine S. L.</creator><creator>Serpell, Jonathan W.</creator><creator>Glover, Anthony R.</creator><scope>24P</scope><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/0009-0001-8864-9757</orcidid></search><sort><creationdate>202406</creationdate><title>Geographic disparities in thyroid cancer staging at presentation: Insights from an Australian context</title><author>Yang, Zihao M. ; Tong, Chai W. ; Bhimani, Nazim ; O’Neill, Christine J. ; Lai, Christine S. L. ; Serpell, Jonathan W. ; Glover, Anthony R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3201-f07897270421f589fce10dd8ced1af3475e52975b22228627b94794b1ffcdfda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Australia</topic><topic>endocrine</topic><topic>Female</topic><topic>Health Services Accessibility - statistics &amp; numerical data</topic><topic>Healthcare Disparities - statistics &amp; numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>New Zealand - epidemiology</topic><topic>oncology</topic><topic>Registries</topic><topic>rural</topic><topic>Rural Population - statistics &amp; numerical data</topic><topic>Thyroid Neoplasms - diagnosis</topic><topic>Thyroid Neoplasms - mortality</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Zihao M.</creatorcontrib><creatorcontrib>Tong, Chai W.</creatorcontrib><creatorcontrib>Bhimani, Nazim</creatorcontrib><creatorcontrib>O’Neill, Christine J.</creatorcontrib><creatorcontrib>Lai, Christine S. L.</creatorcontrib><creatorcontrib>Serpell, Jonathan W.</creatorcontrib><creatorcontrib>Glover, Anthony R.</creatorcontrib><collection>Wiley Online Library Open Access</collection><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>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Zihao M.</au><au>Tong, Chai W.</au><au>Bhimani, Nazim</au><au>O’Neill, Christine J.</au><au>Lai, Christine S. L.</au><au>Serpell, Jonathan W.</au><au>Glover, Anthony R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Geographic disparities in thyroid cancer staging at presentation: Insights from an Australian context</atitle><jtitle>World journal of surgery</jtitle><addtitle>World J Surg</addtitle><date>2024-06</date><risdate>2024</risdate><volume>48</volume><issue>6</issue><spage>1440</spage><epage>1447</epage><pages>1440-1447</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Summary 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 &lt; 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.</abstract><cop>United States</cop><pmid>38733313</pmid><doi>10.1002/wjs.12211</doi><tpages>8</tpages><orcidid>https://orcid.org/0009-0001-8864-9757</orcidid><oa>free_for_read</oa></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Adult
Aged
Australia
endocrine
Female
Health Services Accessibility - statistics & numerical data
Healthcare Disparities - statistics & numerical data
Humans
Male
Middle Aged
Neoplasm Staging
New Zealand - epidemiology
oncology
Registries
rural
Rural Population - statistics & numerical data
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - mortality
Thyroid Neoplasms - pathology
Thyroid Neoplasms - therapy
title Geographic disparities in thyroid cancer staging at presentation: Insights from an Australian context
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