The following is a summary of “Sociodemographic Disparities in the Diagnostic Management of Pediatric Thyroid Nodules” published in the October 2022 issue of Otolaryngol Head Neck Surgery by Moon et al.

The most prevalent endocrine malignant tumor in children is thyroid carcinoma. Variations may strongly influence thyroid cancer outcomes in how thyroid nodules are investigated. The goal of this study is to identify the characteristics that influence whether a biopsy is performed, how quickly it is performed, and the likelihood that a nodule is malignant. Insurance claims data from the Optum Clinformatics Data Mart database were used to conduct this cross-sectional study with a retrospective focus. All children diagnosed with a single thyroid nodule between 2003 and 2020 were included in the analysis. The time period covered by the data study is January 1, 2003, through June 30, 2020.

Biopsy and nodule malignant neoplasm risk factors were identified using multivariable logistic regression analyses. In addition, thyroid nodule diagnostic and biopsy waiting times were analyzed using a multivariate linear regression model. About 11,643 children identified with a single thyroid nodule, 2,117 (18.2%) had a biopsy done (median [IQR] age at diagnosis or treatment, 15 [12-17] years; 8,549 [73.2%] were female, and 3,126 [26.8%] were male). Malignant nodules were detected in 304 (14.4%) individuals who had a biopsy. Lower time from diagnosis to biopsy was seen with higher parental education levels (mean difference, -7.24 days; 95% CI, -13.75 to -0.73). The likelihood of a biopsy being performed was higher for patients who were female and older at the time of nodule diagnosis (odds ratio [OR], 1.25; 95% CI, 1.11-1.40) and lower for patients of Black/African American and Hispanic origin (OR, 0.80; 95% CI, 0.65-0.99). 

The final finding revealed that women did not have a reduced risk of developing nodule malignant neoplasm than men (OR, 1.08; 95% CI, 0.80-1.47). The results of this cross-sectional investigation highlight insights and Implications of Disparities in the diagnostic management of pediatric thyroid nodules. These findings highlight the need for additional efforts to expand access to thyroid care for all children.