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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentation 2 - Care Equity, Quality and Safety

Racial-Ethnic Differences of Social Vulnerability Impact on Pediatric Thyroid Cancer Diagnosis and Surveillance

Monday, October 13, 2025

8:12 AM - 8:18 AM EDT

Location: 107-108

Disclosure(s):

Meredith E. Osmulski, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Daniel C. Chelius, MD, Jr.:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Management disparities of pediatric thyroid cancers (PTC) impact timely diagnosis & surveillance. Studies into inequity drivers have focused on limited social determinants of health (SDoH) across individuals’ socioeconomic status & race, neglecting the interplay of broader, community-level SDoH. Using the Social Vulnerability Index (SVI), we sought to characterize the influence of varied SDoH-vulnerabilities on diagnostic & surveillance differences across racial-ethnic groups of PTC patients.

Methods: This retrospective analysis of 4,324 PTC-patients diagnosed between 1975-2017 from the NCI-Surveillance-Epidemiology-End Results database assessed overall social vulnerability derived from 15 SDoH-factors of socioeconomic, minority-language, household composition, and housing-transportation status. SVI scores were matched to PTC-patients from all US counties. Regressions assessed surveillance length, lymph node metastasis, and number of primary tumors with increasing SVI. Analyses were stratified across (non-Hispanic) White & non-White racial-ethnic groups.

Results: For White (n=2666) & non-White (n=1658) PTC-patients, surveillance times at the lowest & highest-total SVI levels were higher among white (162.92 months and 108.02 months, respectively) compared to non-White patients (117.64; 96.96). For lymph node metastasis, increasing SVI associated with increased occurrence among non-White PTC-patients (OR 1.16, 95%CI 1.05–1.27) but not among White patients. For multiple primary tumors on first presentation, no significant differences were observed across both.

Conclusions: Increasing overall social vulnerability correlated with worse PTC-surveillance, which was exacerbated among non-White patients. It also showed higher lymph node metastasis occurrence solely among non-White patients. In this multilevel SDoH-approach, nuanced considerations of the individual and their community provide key foundations towards targeting limited public health resources against the most pertinent PTC-disparities.

Presenting Author(s)

Meredith E. Osmulski, BS

Medical Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Meredith E. Osmulski, BS

Medical Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
David J. Fei-Zhang, MD, MBA

Resident - Otolaryngology-Head and Neck Surgery
Northwestern University - Feinberg School of Medicine
Chicago, Illinois, United States

Disclosure information not submitted.
Daniel C. Chelius, Jr., MD

Associate Professor
Baylor College of Medicine / Texas Children's Hospital
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jill N. D'Souza, MD

Associate Professor of Otolaryngology- Head and Neck Surgery
Louisiana State University Health and Sciences Center
New Orleans, LA, United States

Disclosure information not submitted.
AS

Anthony M. Sheyn, MD

Division Chief, Pediatric Otolaryngology
Le Bonheur Outpatient Center
Memphis, Tennessee, United States

Disclosure information not submitted.
Jeffrey C. Rastatter, MD

Associate Professor
Ann & Robert H. Lurie Childrens Hospital of Chicago
Chicago, IL, United States

Disclosure information not submitted.

Senior Author(s)

Jeffrey C. Rastatter, MD

Associate Professor
Ann & Robert H. Lurie Childrens Hospital of Chicago
Chicago, IL, United States

Disclosure information not submitted.