Racial and Ethnic Disparities in the Diagnosis and Treatment of Thyroid Disease

Context There are differences in diagnosis, treatment, and outcomes for thyroid between racial and ethnic groups that contribute to disparities. Identifying these differences and their causes are the key to understanding and reducing disparities in presentation and outcomes in endocrine disorders.Evidence Acquisition The present study reviews original studies identifying and exploring differences between benign and malignant thyroid diseases. A PubMed, Web of Science, and Scopus search was conducted for English-language studies using the terms thyroid, thyroid disease, thyroid cancer, race, ethnicity, and disparities from inception to December 31, 2022.Evidence Synthesis Many racial and ethnic disparities in the diagnosis, presentation, treatment, and outcomes of thyroid disease were found. Non-White patients are more likely to have a later time to referral, to present with more advanced disease, to have more aggressive forms of thyroid cancer, and are less likely to receive the appropriate treatment than White patients. Overall and disease-specific survival rates are lower in Black and Hispanic populations when compared to White patients.Conclusions Extensive disparities exist in thyroid disease diagnosis, treatment, and outcomes that may have been overlooked. Further work is needed to identify the causes of these disparities to begin to work toward equity in the care of thyroid disease.

Automated summary

This study reviews original research on differences between benign and malignant thyroid diseases and finds significant disparities in diagnosis, treatment, and outcomes among racial and ethnic groups. Non-White patients experience longer referral times, more advanced disease, aggressive forms of thyroid cancer, and less appropriate treatment compared to White patients. Overall and disease-specific survival rates are lower in Black and Hispanic populations. Further research is needed to understand the causes of these disparities and promote equitable care for thyroid disease.