Sex differences and racial/ethnic disparities in the presentation and treatment of medullary thyroid cancer.

ABSTRACT

BACKGROUND: This study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC). METHODS: Patients with MTC (2010-2020) were identified from the National Cancer Database. Differences in disease presentation and likelihood of guideline-concordant surgical management (total thyroidectomy and resection of ≥1 lymph node) were assessed by sex and race/ethnicity. RESULTS: Of 6154 patients, 68.2% underwent guideline-concordant surgery. Tumors >4 â€‹cm were more likely in men (vs. women OR 2.47, p â€‹< â€‹0.001) and Hispanic patients (vs. White patients OR 1.52, p â€‹= â€‹0.001). Non-White patients were more likely to have distant metastases (Black OR 1.63, p â€‹= â€‹0.002; Hispanic OR 1.44, p â€‹= â€‹0.038) and experienced longer time to surgery (Black HR 0.66, p â€‹< â€‹0.001; Hispanic HR 0.71, p â€‹< â€‹0.001). Black patients were less likely to undergo guideline-concordant surgery (OR 0.70, p â€‹= â€‹0.022). CONCLUSIONS: Male and non-White patients with MTC more frequently present with advanced disease, and Black patients are less likely to undergo guideline-concordant surgery.