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 SEER registries (N=2632, 63% response rate). Patients identified their primary care physicians (PCP), 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 (OR: 1.68, 95%CI: 1.24-2.27). Patients ≥65years (vs. <45years) 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.
2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment
