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PurposeThyroid cancer incidence is rising, possibly secondary to increased imaging and surveillance. Based on rural access to care disparities, we hypothesized that incidence would be greater in urban compared to rural counties with no significant difference in long‐term survival.MethodsAn observational study was performed on thyroid cancer patients using Surveillance Epidemiology and End Results data (2000‐2012). Age‐adjusted incidence rates, incidence rate ratios, and survival rates were calculated across rural‐urban designations.FindingsIncidence rates were 11.2, 9.8, and 10.1 per 100,000 for urban, rural‐adjacent, and rural‐nonadjacent counties, respectively. Statistically significantly lower incidence was noted in rural‐adjacent and rural‐nonadjacent compared to urban areas. Five‐year and 10‐year survival was significantly lower in rural‐nonadjacent counties compared to urban counties.ConclusionsHigher incidence and increased long‐term survival for thyroid cancer were noted in urban areas compared to rural areas. It is uncertain if rural‐urban differences in long‐term survival reflect health care disparities, differences in therapy, or other origins.

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Asymptomatic primary hyperparathyroidism is a very common endocrine condition, yet management of this disease process remains controversial. Primary hyperparathyroidism can lead to a myriad of symptoms which not only decreases the quality of life of patients but also increases the risk of cardiovascular disease, osteoporosis, and kidney stones. Parathyroidectomy is the only known cure for the disease. This review explores the definition of asymptomatic primary hyperparathyroidism, the burden of disease, and the overwhelming benefits of parathyroidectomy.