Cancer disparities and thyroid carcinoma

PURPOSE OF REVIEW: Disparities in cancer incidence and patient outcomes are now recognized as commonly due to socioeconomic parameters in addition to more traditional risk factors such as gender and toxic exposure. For thyroid carcinoma, studies published during the past 10 years have now focused on identifying these contributing factors to disparities. RECENT FINDINGS: The incidence of thyroid carcinoma is clearly increased due to radiation exposure, with recent emphasis on increased risk for persons exposed to radioactive fallout from above-ground nuclear testing performed in the 1950s. Among women, who have higher incidence rates of differentiated thyroid carcinoma, risk is higher if menarche did not occur between the ages of 12 and 14. Women who have emigrated from south-east Asia may have higher rates of thyroid cancer, whereas lower rates occur in African-Americans. Occupations associated with higher risks include those with increased exposure to known toxins such as radiation and dioxins, but also school teachers, for less obvious reasons. Cigarette smokers and regular exercisers have lower incidence rates. SUMMARY: Although socioeconomic factors are increasingly recognized as important to understanding cancer disparities, only weak associations have been described for thyroid cancer incidence and outcomes.