Marital status, race/ethnicity, and outcomes in well-differentiated thyroid cancer in the elderly

Background: There is limited research examining the effect of marital status on outcomes for patients with well-differentiated thyroid carcinoma, particularly among patients ≥55 years of age and by race/ethnicity. This study aimed to better characterize the interplay between age, race, and marital status in the treatment and prognosis for patients with well-differentiated thyroid carcinoma. Methods: A retrospective, observational study of 12,779 patients ≥55 years of age with well-differentiated thyroid carcinoma was conducted using the Surveillance, Epidemiology, and End Results registry from January 1, 1988 to December 31, 2013. Marital status was classified as married, single, separated/divorced, widowed, and “other”. Race/ethnicity was classified as White non-Hispanic, Black non-Hispanic, Hispanic, Asian and “other”. Disease-specific survival was analyzed controlling for patient, disease, and treatment characteristics. A secondary analysis of overall survival, defined as death from any cause, was performed. Survival analyses were performed focusing on effects for marital status and race/ethnicity. Results: Widowed status, increasing age, male sex, distant stage, local excision, and external beam radiation were associated with significantly worse disease-specific survival. When compared to their married counterparts, widowed patients ≥65 years of age and widowed Black non-Hispanic patients both had significantly worse overall survival, while widowed White non-Hispanic patients had significantly worse overall and disease-specific survival. Conclusions: Our study elucidates the impact of widowed marital status and race/ethnicity have on mortality amongst older patients with well-differentiated thyroid carcinoma.