很少有研究探讨儿童甲状腺癌护理机会的差异。我们试图澄清影响儿科分化型甲状腺癌和侵袭性甲状腺乳头状癌的护理机会的社会经济和患者因素。利用国家癌症数据库，我们对儿科分化型甲状腺癌和侵袭性甲状腺乳头状癌进行了回顾性研究（ 2004-2019）。患者被分为三个时期（2004-2008年、2009-2013年、2014-2019年）来评估趋势。使用 χ2 分析和 Kruskal-Wallis 检验来测试每个社会经济和疾病相关因素的分组独立性。总共分析了 6,275 名儿童分化型甲状腺癌患者和 182 名侵袭性甲状腺乳头状癌患者。近年来（2014-2019 年），享受医疗补助的差异化甲状腺癌患者（中位数 18.0 英里）和来自低收入家庭的患者（中位数 21-30 英里）不得不走更远的距离接受治疗。种族/民族差异很明显；黑人和西班牙裔患者等待手术超过 30 天的几率高于白人患者（比值比分别为 1.39、1.49、P < .05）。与白人和西班牙裔患者相比，患有分化型甲状腺癌的黑人患者的死亡风险更高（风险比 4.31，95% 置信区间：1.95-9.51，P < .05）。西班牙裔分化型甲状腺癌患者的淋巴结阳性率较高（60%，P < .05，白人患者为 51%，黑人患者为 36%）。社会经济因素并没有显着影响侵袭性甲状腺乳头状癌的生存或淋巴结阳性。这项研究强调了儿童分化型甲状腺癌和侵袭性甲状腺乳头状癌在获得护理和生存结果方面的差异。种族、收入状况和保险类型都对这些差异产生了影响。了解复杂的病因并制定干预措施以改善可及性和患者治疗效果至关重要。版权所有 © 2023 Elsevier Inc. 保留所有权利。

Few studies have examined the disparities in access to care for pediatric thyroid cancers. We sought to clarify socioeconomic and patient factors that affect access to care for pediatric differentiated thyroid cancer and aggressive variants of papillary thyroid cancer.Using the National Cancer Database, we performed a retrospective study on pediatric differentiated thyroid cancer and aggressive variants of papillary thyroid cancer (2004-2019). Patients were divided into three periods (2004-2008, 2009-2013, 2014-2019) to assess for trends. The χ2 analysis and Kruskal-Wallis test were used to test for independence of groupings for each socioeconomic and disease-related factor.In all, 6,275 patients with pediatric differentiated thyroid cancer and 182 with aggressive variants of papillary thyroid cancer were analyzed. Differentiated thyroid cancer patients with Medicaid (median 18.0 miles) and those from lower-income households (median 21-30 miles) had to travel greater distances for care in recent years (2014-2019). Racial/ethnic disparities were evident; Black and Hispanic patients have higher odds of waiting >30 days for surgery (odds ratio 1.39, 1.49, P < .05, respectively) than White patients. Black patients with differentiated thyroid cancer had a higher risk of mortality compared with White and Hispanic patients (hazard ratio 4.31, 95% confidence interval: 1.95-9.51, P < .05). Nodal positivity was higher in Hispanic patients with differentiated thyroid cancer (60%, P < .05, White patients 51% and Black patients 36%). Socioeconomic factors did not significantly affect survival or nodal positivity in aggressive variants of papillary thyroid cancer.This study highlights disparities in access to care and survival outcomes in pediatric differentiated thyroid cancer and aggressive variants of papillary thyroid cancer. Race, income status, and type of insurance all play a role in these disparities. Understanding the complex etiologies and developing interventions to improve access and patient outcomes are crucial.Copyright © 2023 Elsevier Inc. All rights reserved.