Surgeon Training and Use of Radioactive Iodine in Stage I Thyroid Cancer Patients
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The majority of thyroid cancer diagnoses in the United States are stage I well-differentiated cancer. The use of radioactive iodine (RAI) in these low-risk patients has increased over time. The role of surgeon training in decision making regarding treatment with RAI is unknown.
Thyroid surgeons affiliated with 368 hospitals associated with the US National Cancer Database (NCDB) were surveyed. Survey data were linked to the NCDB data. A multivariable weighted analysis controlling for surgeon and hospital characteristics was conducted to examine the relationship between surgeon training, continuing education and hospital-level RAI use for stage I well-differentiated thyroid cancer.
The response rate was 70 % (560 of 804). In both univariate and multivariable analysis controlling for hospital case volume, practice setting and surgeon specialty, training with a thyroid surgeon was associated with less RAI use for stage I thyroid cancer (P = 0.022 and 0.028, respectively). Attending one or more professional society meetings a year was associated with a lower rate of hospital-level RAI use in univariate analysis (P = 0.044) but not multivariable analysis.
Training with a surgeon or group of surgeons who focus on thyroid surgery was associated with a lower proportion of stage I thyroid cancer patients receiving RAI after total thyroidectomy. This study emphasizes the importance of surgeon training in hospital practice patterns.
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- Surgeon Training and Use of Radioactive Iodine in Stage I Thyroid Cancer Patients
Annals of Surgical Oncology
Volume 20, Issue 3 , pp 733-738
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- 1. Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
- 2. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- 3. National Cancer Database, Commission on Cancer, American College of Surgeons, Chicago, IL, USA
- 4. Department of Surgery, Boston University, Boston, MA, USA
- 5. Department of Medicine, University of Michigan, Ann Arbor, MI, USA