Demographic and socioeconomic factors of follicular thyroid carcinoma.

Abstract

e18125 Background: Follicular thyroid carcinoma (FTC) is an atypical malignancy that develops within the follicular cells of the thyroid. One study found that patients identified with FTC became minimally angioinvasive (38%) or capsular and angioinvasive (34%). Despite FTC’s rarity, understanding the epidemiology of the disease through analysis of the diagnostic and socioeconomic factors could provide insight into FTC. The National Cancer Database (NCDB) was employed to identify potential demographic and socioeconomic trends in FTC patients to perform a comprehensive study. Methods: Data acquired between the years of 2018 to 2020 from the National Cancer Database (NCDB), compiling a histologically-verified patient set (ICD-O-3 code 8339), was used to perform a retrospective cohort analysis. Analysis of demographic factors (race, sex, age, educational attainment, insurance status, facility type, Hispanic status, distance to treatment, and Charlson-Deyo score) were determined through regression analysis using comprehensive statistics and noticeable trends. Results: Of the 736 patients with FTC, patients were more likely white (75%), with an increased occurrence of FTC among females (66%). The most common payor was private insurance (60%), followed by Medicare (25%). Compared to the other income quartiles, more patients were found to be in the highest income quartile (28%). Individuals traveled an average distance of 27.4 miles (SD = 46) for treatment. Upon diagnosis, the mean age was 51.5 years (SD = 17.71). All cases of FTC had a primary site residing in the thyroid gland. Based on NCDB analytic staging, most patients' diagnoses were in Stage I (70%), followed by Stage II (22%). Over half of the individuals with FTC underwent surgical intervention at the primary site (64%), with a sizeable majority demonstrating no residual tumor (89%). Outside of surgical intervention, the primary treatment methods consisted of radiation treatment (55%) or hormone therapy (57%). Individuals with follicular thyroid carcinoma, typically presented with a Charlson-Deyo comorbidity score of zero (81%). Most patients reached the two-year survival mark (98%) and the end of the four-year follow-up period (97%). Conclusions: This is one of the first NCDB analyses on follicular thyroid carcinoma, focused on addressing a significant knowledge gap on prevalent clinical and demographic trends. In alignment with current research, surgical intervention with either radiation or hormone therapy has been utilized in treating FTC. Socioeconomic factors such as payor upon diagnosis and patient distance from the hospital have not been investigated for FTC until this study. Given the average age of diagnosis is around 51 and that 25% of patients rely on Medicare, further analysis of demographic factors is crucial for developing targeted preventative strategies for individuals with follicular thyroid carcinoma.