Demographic and socioeconomic factors predictive of compliance with American Thyroid Association guidelines for the treatment for advanced papillary thyroid carcinoma

Head Neck. 2015 Dec;37(12):1776-80. doi: 10.1002/hed.23831. Epub 2014 Sep 25.

Abstract

Background: The American Thyroid Association (ATA) publishes evidence-based guidelines for the treatment of papillary thyroid carcinoma (PTC). We sought to identify factors associated with receiving treatment compliant with the 2006 ATA guidelines for advanced-stage PTC.

Methods: The 2006 ATA guideline compliance was examined in patients with stage III and IV PTC extrapolated from Surveillance, Epidemiology, and End Results (SEER).

Results: Sixty percent of patients received ATA-compliant treatment. A stepwise increase in compliance occurred between 2006 and 2009 (p-value trend = .0003). Age 45 to 64 years versus ≥65 (odds ratio [OR] = 0.682; 95% confidence interval [CI] = 0.57-0.81; p < .0001) and higher income (p trend = .012) were associated with an increased likelihood of receiving ATA-compliant care. African Americans (OR = 0.56; 95% CI = 0.42-0.76; p = .0001) and single patients (OR = 0.81; 95% CI = 0.67-0.97; p = .02) were less likely to receive ATA-compliant care.

Conclusion: This study highlights specific populations at risk for receiving non-ATA-compliant care for PTC and underscores the need to further implement guideline-based practice.

Keywords: American Thyroid Association (ATA) guidelines; disparities; papillary thyroid carcinoma; socioeconomic status; thyroid cancer.

MeSH terms

  • Aged
  • Asian / statistics & numerical data
  • Black or African American / statistics & numerical data*
  • Carcinoma / drug therapy*
  • Carcinoma / ethnology*
  • Carcinoma, Papillary
  • Endocrinology
  • Female
  • Guidelines as Topic
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Lymph Node Excision / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Patient Compliance* / statistics & numerical data
  • Poverty / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Societies, Medical
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / drug therapy*
  • Thyroid Neoplasms / ethnology*
  • Treatment Outcome
  • United States / epidemiology
  • White People / statistics & numerical data*

Substances

  • Iodine Radioisotopes