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Use of radioactive iodine for thyroid cancer Full Text
JAMA, 08/17/2011
Clinical Article
Haymart MR et al. – Among patients treated for well-differentiated thyroid cancer at hospitals in the National Cancer Database, there was an increase in the proportion receiving radioactive iodine between 1990 and 2008; much of the variation in use was associated with hospital characteristics.
Methods- Time trend analysis of radioactive iodine use in cohort of 189,219 patients with well-differentiated thyroid cancer treated at 981 hospitals associated with US National Cancer Database between 1990 and 2008
- Used multilevel analysis to assess correlates of patient and hospital characteristics on radioactive iodine use in cohort treated from 2004 to 2008
- Between 1990 and 2008, across all tumor sizes, there was significant increase in proportion of patients with well-differentiated thyroid cancer receiving radioactive iodine (1373/3397 [40.4%] vs 11 539/20 620 [56.0%]; P < .001)
- Multivariable analysis of patients treated from 2004 to 2008 found that there was statistical difference in radioactive iodine use between American Joint Committee on Cancer stages I and IV ( OR, 0.34; 95% CI, 0.31-0.37) but not between stages II/III and IV (for stage II vs stage IV, OR, 0.97; 95% CI, 0.88-1.07 and for stage III vs stage IV, OR, 1.06; 95% CI, 0.95-1.17)
- In addition to patient and tumor characteristics, hospital volume was associated with radioactive iodine use
- Wide variation in radioactive iodine use existed, and only 21.1% of this variation was accounted for by patient and tumor characteristics
- Hospital type and case volume accounted for 17.1% of variation
- After adjusting for available patient, tumor, and hospital characteristics, 29.1% of variance was attributable to unexplained hospital characteristics