Physician Specialties Involved in Thyroid Cancer Diagnosis and Treatment: Implications for Improving Health Care Disparities

J Clin Endocrinol Metab. 2022 Feb 17;107(3):e1096-e1105. doi: 10.1210/clinem/dgab781.


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 Surveillance, Epidemiology and End Results registries (N = 2632, 63% response rate). Patients identified their primary care physicians (PCPs), 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 (odds ratio [OR]: 1.68; 95% CI, 1.24-2.27). Patients ≥65 years (vs <45 years) 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.

Keywords: endocrinologists; healthcare disparities; physicians; primary care; surgeons; thyroid neoplasms.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cohort Studies
  • Endocrinologists / organization & administration
  • Endocrinologists / statistics & numerical data
  • Female
  • Healthcare Disparities*
  • Humans
  • Male
  • Middle Aged
  • Physicians, Primary Care / organization & administration
  • Physicians, Primary Care / statistics & numerical data
  • Practice Patterns, Physicians' / organization & administration*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Quality Improvement*
  • Referral and Consultation / organization & administration
  • Referral and Consultation / statistics & numerical data
  • SEER Program / statistics & numerical data
  • Surgeons / organization & administration
  • Surgeons / statistics & numerical data
  • Surveys and Questionnaires / statistics & numerical data
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / therapy*
  • Vulnerable Populations / statistics & numerical data