Higher Distressed Communities Index is associated with more aggressive features in papillary thyroid cancer

Abstract

Background: We sought to identify associations between living in an economically distressed community and the oncologic features and mutational status of papillary thyroid cancer (PTC).

Methods: Patients with PTC were identified retrospectively. Community distress was estimated using the Distressed Communities Index (DCI). Logistic regression was used to assess associations between DCI, oncologic features, and tumor mutational status.

Results: Among 1062 patients, those from "at risk" (9.6%) or "distressed" (7.1%) communities were more likely to have tumors >4 ​cm (aOR 2.13, 95% CI 1.15-3.95), experience disease recurrence (aOR 1.84, 95% CI 1.16-2.91), and die due to thyroid cancer (aOR 3.56, 95% CI 1.26-10.05) compared to those in "prosperous" (41.6%) communities. No associations were found between DCI and tumor mutations or multifocality.

Conclusions: Patients from "distressed" communities are diagnosed with more advanced thyroid cancer with higher rates of recurrence and death despite no differences in tumor mutational profile.

Keywords: Distressed communities index; Economic distress; Papillary thyroid cancer; Thyroid cancer outcomes; Tumor mutations.