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. 2022 Feb 17;107(3):e1096-e1105.
doi: 10.1210/clinem/dgab781.

Physician Specialties Involved in Thyroid Cancer Diagnosis and Treatment: Implications for Improving Health Care Disparities

Archana Radhakrishnan  1 , David Reyes-Gastelum  2 , Paul Abrahamse  1 , Brittany Gay  2 , Sarah T Hawley  1 , Lauren P Wallner  1 , Debbie W Chen  2 , Ann S Hamilton  3 , Kevin C Ward  4 , Megan R Haymart  2
Affiliations

Physician Specialties Involved in Thyroid Cancer Diagnosis and Treatment: Implications for Improving Health Care Disparities

Archana Radhakrishnan et al. J Clin Endocrinol Metab. .

Abstract

Context: Little is known about provider specialties involved in thyroid cancer diagnosis and management.

Objective: Characterize providers involved in diagnosing and treating thyroid cancer.

Design/setting/participants: We surveyed patients with differentiated thyroid cancer from the Georgia and Los Angeles County Surveillance, Epidemiology and End Results registries (N = 2632, 63% response rate). Patients identified their primary care physicians (PCPs), who were also surveyed (N = 162, 56% response rate).

Main outcome measures: (1) Patient-reported provider involvement (endocrinologist, surgeon, PCP) at diagnosis and treatment; (2) PCP-reported involvement (more vs less) and comfort (more vs less) with discussing diagnosis and treatment.

Results: Among thyroid cancer patients, 40.6% reported being informed of their diagnosis by their surgeon, 37.9% by their endocrinologist, and 13.5% by their PCP. Patients reported discussing their treatment with their surgeon (71.7%), endocrinologist (69.6%), and PCP (33.3%). Physician specialty involvement in diagnosis and treatment varied by patient race/ethnicity and age. For example, Hispanic patients (vs non-Hispanic White) were more likely to report their PCP informed them of their diagnosis (odds ratio [OR]: 1.68; 95% CI, 1.24-2.27). Patients ≥65 years (vs <45 years) were more likely to discuss treatment with their PCP (OR: 1.59; 95% CI, 1.22-2.08). Although 74% of PCPs reported discussing their patients' diagnosis and 62% their treatment, only 66% and 48%, respectively, were comfortable doing so.

Conclusions: PCPs were involved in thyroid cancer diagnosis and treatment, and their involvement was greater among older patients and patients of minority race/ethnicity. This suggests an opportunity to leverage PCP involvement in thyroid cancer management to improve health and quality of care outcomes for vulnerable patients.

Keywords: endocrinologists; healthcare disparities; physicians; primary care; surgeons; thyroid neoplasms.

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Figures

Figure 1.
Figure 1.
Patient and PCP cohort selection.
Figure 2.
Figure 2.
Multivariable-adjusted odds ratios (OR) and 95% CIs of patient characteristics associated with type of provider (primary care provider, surgeon, or endocrinologist) who informed the patient about the thyroid cancer diagnosis.
Figure 3.
Figure 3.
Multivariable-adjusted odds ratios (OR) and 95% CIs of patient characteristics associated with type of provider (primary care provider, surgeon, or endocrinologist) with whom patient discussed treatment.
Figure 4.
Figure 4.
Distribution of PCP-report of involvement in thyroid cancer diagnosis and treatment.
See this image and copyright information in PMC

Comment in

References

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