Association of Treatment and Cancer Evidence for Localized Stages of Papillary Thyroid Cancer in Florida

Signature Grand, Davie, Florida, USA

Objectives. Does evidence of cancer post-intervention depend on the patient’s age and the type of treatment received? Background. Thyroid cancer is the most common malignancy that affects the tissues of the endocrine system, and affects women more often then men, usually between the ages of 25 and 65. Currently, the most common types of treatments are surgery or surgery followed by an adjuvant therapy. Methods. This study has a design similar to a crosssectional study, but dealing with incident cases. We studied 3910 individuals with localized papillary thyroid cancer diagnosed in the state of Florida between January 1st 1994 and December 31st 2002, using the relative risk as a measure of association and the corresponding attributable risk % (AR%) for risk causality. The main association was between evidence of cancer (evidence vs. no evidence), and treatment type (surgery+adjuvant therapy vs surgery alone). The Mantel- Haenszel stratified methodology was used to identify confounders and effect modifiers. Results. Ethnicity, gender and geographical location, were nor confounders nor effect modifiers. Age was found to be a risk factor, with the highest evidence of cancer found in the age 60+ group. Surprisingly, the age <45 group had higher evidence of cancer than did the age 45-60 group. In>addition, surgery plus adjuvant therapy had greater evidence of cancer than did surgery alone. Practically, surgery alone is a better treatment than surgery+adjuvant therapy, for localized stage with papillary morphology. Conclusion. Our analysis shows that the two age groups that had the worst prognosis were the <45 and>60+ age groups. We can infer that the increased age and declining overall health in the elderly population influences these results. For the younger population, it may be attributed to a more severe case of cancer or another underlying immunological problem. Grants and Acknowledgement. This study was funded in part through the HPD Research Grant for Florida Cancer Registry Analysis, 2004-2007. The views expressed herein are solely those of the authors and do not necessarily reflect those of FCDS, the contractor of FL-DOH.