Thyroid cancer in Hawaii: concern for ethnic disparity in the Filipino population

Abstract

Background: Thyroid cancer is the most common endocrine malignancy. It is noteworthy that thyroid cancer is more common in particular geographic regions such as Hawaii. Additionally, there appears to be an ethnic predilection of thyroid cancer within particular groups such as the Filipino population in Hawaii. Outside the confines of ethnicity, other potential putative biologic determinants of aggression include genetic and protein alterations. Objective: Due to the higher preponderance of thyroid cancer within distinct populations, our principal goal was to comprehensively assess if there was an ethnic disparity of survival in Hawaii. Methods: This was a retrospective review of 622 patients with thyroid cancer treated at a tertiary care facility in Honolulu, HI from January 1, 1990 through December 2008. In addition, tissue biospecimens of 10 Filipino patients with papillary thyroid carcinoma from within the study cohort were subjected to DNA as well as protein characterization. A log-rank test was implemented to determine survival between the Filipino and non-Filipino cohorts. In order to model the survival of Filipinos vs. non-Filipinos adjusted for by age, gender, extra-thyroidal extension, and AJCC stage, regression analysis via the Cox proportional hazards model was utilized; hazard ratios with confidence intervals were computed.