WIP 58 - Do Socioeconomic Disparities Affect the Rate of Malignancy in Pediatric Thyroid Nodules? A Retrospective Study at a Single Institution in an Underserved Community

Raena E. Greenbaum, Albert Einstein College of Medicine, Bronx, NY, United States; Sofia F. Cataliotti, Albert Einstein College of Medicine, ROSLYN HEIGHTS, NY, United States; Ariella D. Simoni, Albert Einstein College of Medicine, Bronx, NY, United States; Mona Gangar, The Children's Hospital at Montefiore, Bronx, NY, United States; Liane Eng, The Children's Hospital at Montefiore, Bronx, NY, United States; Leslie Lam, Children's Hospital at Montefiore, Flushing, NY, United States

Background: Thyroid cancer is the most common endocrine cancer in the pediatric population. Few studies have identified the role of social determinants of health in the care of pediatric thyroid nodules. Disparities in patient level of socioeconomic distress may impact outcomes and treatment timelines. We hypothesize that a higher rate of malignancy (RoM) and longer time to biopsy or surgery will be correlated with a higher Distressed Communities Index (DCI) score.

Objective: We aim to investigate the correlation between socioeconomic distress and RoM in pediatric patients with thyroid nodules at the Children’s Hospital at Montefiore (CHAM), in the Bronx, New York. We also aim to explore disparities in RoM and time to biopsy or surgery in our population.

Design/Methods: This study was approved by the Albert Einstein College of Medicine IRB. A retrospective chart review of 110 patients ages 0-21 years who were evaluated for a thyroid nodule at CHAM from 2005 to 2024 was performed. The primary outcome is RoM. Secondary outcomes are the number of days to biopsy and surgery from initial consultation. Patient community-level socioeconomic distress is quantified by DCI score. DCI is a data tool which provides a score from 0 (most prosperous) to 100 (most distressed) based on zip code. Preliminary data shows a total RoM of 51% (n=59) in the subset of our patients who underwent surgical resection for their nodules, in contrast to the rate of malignancy of 19-34% reported in recent literature. This finding is of interest given that the average DCI in the study population is 80 compared to the national average of 50. Average DCI score among patients found to have malignant vs. benign pathology was 80 vs. 73. Furthermore, higher DCI score shows correlation with a longer time from initial consultation to biopsy. Further statistical analysis and validation is ongoing. Univariate analysis and multivariate logistic regression will be performed. Finalization of data analysis is expected December 2024.