Socioeconomic determinants are known to impact the severity of various cancers at presentation. A recent Surveillance, Epidemiology, and End Results (SEER) cancer registry review concluded that several demographic factors had no impact on risk of nodal metastasis in pediatric papillary thyroid cancer (PTC). However, this study did not analyze multiple other socioeconomic determinants which we hypothesize may impact disease severity. We analyzed pediatric patients of less than 20 years of age with PTC during 2010–2014 in the SEER database. Patients were stratified both by AJCC summary stage (Local Disease-LD versus Regional/Distant Disease- RDD) and by American Thyroid Association (ATA) pediatric PTC low/high risk classification. Socioeconomic variables analyzed included race, Hispanic origin, insurance, and county-of-origin characteristics (education status, median income, language isolation and poverty level). Considering summary stage data, Hispanics versus Non-Hispanic Caucasians (NHC) had a lower incidence of LD (2.62/million v 4.86/M, RR= 0.54, P < 0.00) and similar rate of RDD (4.96/M v 5.23/M, RR= 0.95, p = 0.6). Therefore, for Hispanics versus NHC with PTC, there was a higher risk of having RDD rather than LD disease (OR= 1.76, 95% CI 1.30–2.38, p = 0.0002). Among patients with PTC, there was no significant risk for RDD versus LD considering case-based insurance status or county-level education, poverty, income, or language isolation status. Approximate ATA risk-stratification by splitting N1a and N1b disease between the low and high risk groups respectively demonstrated no impact of any socioeconomic determinants on the severity of disease presentation. Patients of Hispanic origin with PTC may have a higher risk of advanced disease versus NHC. This may be due to lower recognition of localized disease in the Hispanic population. Other socioeconomic determinants do not seem to affect the severity of PTC in the pediatric population. Major limitations are that the SEER database does not collect nodal data in a mannor that allows for risk straification by the ATA guidelines and does not collect various casebased socioeconomic factors allowing only county/state level analysis.
