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Demographic and socioeconomic factors predictive of compliance with American Thyroid Association guidelines for the treatment for advanced papillary thyroid carcinoma
Author(s) -
Wenaas Ashley E.,
Nagy Celeste Z.,
Yiu Yin,
Xu Li,
Horter Kelsey,
Zevallos Jose P.
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23831
Subject(s) - medicine , guideline , odds ratio , socioeconomic status , confidence interval , thyroid carcinoma , thyroid cancer , epidemiology , propensity score matching , thyroid , population , pathology , environmental health
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. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1776–1780, 2015