Thyroid carcinoma
Of 567 patients diagnosed with thyroid carcinoma, two patients were children. Separately, 45.31% of thyroid carcinomas diagnosed at autopsy were found in patients between 50-and 70-years old Figure 1 . Most patients in this group died between the age of 60 and 64 (15.34%). There was a decrease in the incidence of thyroid cancer diagnosed at autopsy between the years 2000 and 2017 (β = - 1.402, p=0.001). A summary of thyroid cancer characteristics examined is shown inTable 1 . Of the cases reviewed, 87.79% of the cancers were papillary carcinomas. Of the 277 thyroid carcinomas with documented staging, 231 patients had stage 1, 13 patients had stage 2, 10 patients had stage 3, and 25 patients had stage 4. The median tumor size was 7mm. Of 271 patients with documented AJCC stages, the TMN staging, and their frequencies were as follows: T1/T2 (91.14%), T3/T4 (8.86%); nodal positivity (5.66%), and M1 (4.95%). Most patients (59.82%) had a median household income between $50,000 and $75,000.
Thyroid carcinoma was the cause of death in 17 (3.01%) patients in this group (8 papillary thyroid cancer, 3 follicular thyroid carcinoma, 1 anaplastic thyroid cancer, 1 medullary thyroid cancer, 1Hurthle cell carcinoma, and 3 unspecified). Of the 17 patients with thyroid cancer related deaths, 10 patients had specific AJCC staging: 3 (30.00%) had stage 1 disease and 7 (70.00%) had stage 4 disease. The three most common causes of deaths this cohort were heart disease (26.19%), accident (9.20%), and infection (6.19%). There was no significant difference between black and white patients (RR=2.60, 95%CI: 0.891-7.57, p=0.080). Patients over 70 years old were at lower risk of thyroid-related deaths than those under 50 (RR=0.125, 95%CI: 0.016-1.001, p=0.025). There was no significant difference in thyroid-related deaths in patients 50-70 years old and patients over 70 years old (RR=0.723, 95% CI: 0.275, 1.901, p=0.256). Thyroid cancer-related deaths were more prevalent in females (RR=3.37, 95% CI: 1.095-9.59, p=0.033), in tumors larger than 4cm (RR=14.47, 95% CI: 3.155-66.36, p<0.001), and in stage 3 or 4 disease (RR=24.91, 95%CI: 5.39-115.0, p<0.0001) compared to males, tumors less than 4cm, and stage 1 or 2 disease, respectively.
Patients with non-thyroid HNC were 17.1 (95%CI: 9.55-30.6, p<0.001) times more likely to have cancer-related death found at autopsy than thyroid carcinoma.