Table 2.
RAI Use for Medium-Risk Thyroid Cancer
| Patients, n, % |
OR (95% CI) |
|||
|---|---|---|---|---|
| Overall | Treated With RAI | Unadjusted | Adjusted | |
| Hospital characteristics | ||||
| Hospital region | ||||
| EN Central | 6845 (15.9) | 4826 (70.5) | 0.52 (0.36–0.75) | 0.55 (0.38–0.80) |
| ES Central | 2672 (6.2) | 1707 (63.9) | 0.44 (0.28–0.70) | 0.46 (0.29–0.72) |
| Mid-Atlantic | 7250 (16.8) | 4489 (61.9) | 0.24 (0.16–0.36) | 0.23 (0.16–0.34) |
| Mountain | 2811 (6.5) | 2060 (73.3) | 0.85 (0.51–1.40) | 0.73 (0.44–1.19) |
| New England | 2958 (6.9) | 1699 (57.4) | 0.23 (0.15–0.36) | 0.24 (0.15–0.38) |
| Pacific | 5971 (13.9) | 4094 (68.6) | 0.55 (0.37–0.82) | 0.50 (0.34–0.74) |
| S Atlantic | 8040 (18.7) | 5438 (67.6) | 0.44 (0.30–0.64) | 0.43 (0.30–0.63) |
| WS Central | 3125 (7.3) | 1831 (58.6) | 0.35 (0.23–0.54) | 0.33 (0.22–0.51) |
| WN Central | 3395 (7.9) | 2585 (76.1) | 1.0 (Reference) | 1.0 (Reference) |
| Case volume (cases/y) | ||||
| Low (≤11) | 4460 (10.4) | 2438 (54.7) | 0.46 (0.37–0.59) | 0.49 (0.39–0.62) |
| Medium (12–34) | 14 980 (34.8) | 10 007 (66.8) | 0.87 (0.69–1.10) | 0.85 (0.68–1.07) |
| High (≥35) | 23 627 (54.9) | 16 284 (68.9) | 1.0 (Reference) | 1.0 (Reference) |
| Patient characteristics | ||||
| Sex | ||||
| Female | 33 541 (77.9) | 22 288 (66.5) | 0.95 (0.90–1.01) | 0.96 (0.91–1.02) |
| Male | 9526 (22.1) | 6441 (67.6) | 1.0 (Reference) | 1.0 (Reference) |
| Age (y) | ||||
| <20 | 1144 (2.7) | 822 (71.9) | 1.50 (1.29–1.75) | 1.10 (0.92–1.31) |
| 20–44 | 21 553 (50.0) | 14 697 (68.2) | 1.30 (1.22–1.38) | 1.05 (0.96–1.14) |
| 45–59 | 12 046 (28.0) | 7938 (65.9) | 1.17 (1.09–1.25) | 1.08 (0.99–1.18) |
| ≥60 | 8324 (19.3) | 5272 (63.3) | 1.0 (Reference) | 1.0 (Reference) |
| Charlson-Deyo comorbidity index score | ||||
| 0 | 37 853 (87.9) | 25 324 (66.9) | 1.13 (1.06–1.22) | 1.08 (1.00–1.16) |
| ≥1 | 5214 (12.1) | 3405 (65.3) | 1.0 (Reference) | 1.0 (Reference) |
| Race/ethnicity | ||||
| Black | 2787 (6.5) | 1748 (62.7) | 0.92 (0.83–1.01) | 1.01 (0.91–1.11) |
| Other | 6994 (16.2) | 4547 (65.0) | 1.02 (0.95–1.10) | 0.99 (0.92–1.07) |
| White | 33 286 (77.3) | 22 434 (67.4) | 1 (Reference) | 1 (Reference) |
| Insurance | ||||
| Insurance, NOS | 6957 (16.4) | 4611 (66.3) | 0.94 (0.87–1.01) | 0.93 (0.87–1.01) |
| Medicaid/uninsured | 3354 (7.9) | 2124 (63.3) | 0.80 (0.73–0.88) | 0.80 (0.73–0.88) |
| Medicare | 5845 (13.8) | 3632 (62.1) | 0.73 (0.69–0.79) | 0.84 (0.76–0.92) |
| Private/government | 26 157 (61.8) | 17 990 (68.8) | 1 (Reference) | 1 (Reference) |
| Rural-urban continuum | ||||
| Metro population | 34 081 (86.0) | 22 614 (66.4) | 1.08 (1.00–1.17) | 1.06 (0.98–1.16) |
| Other | 5528 (14.0) | 3770 (68.2) | 1 (Reference) | 1 (Reference) |
| Tumor characteristics | ||||
| Tumor histology | ||||
| Papillary | 38 358 (89.1) | 25 681 (67.0) | 1.18 (1.10–1.27) | 1.07 (0.99–1.16) |
| Follicular/Hurthle cell | 4709 (10.9) | 3048 (64.7) | 1 (Reference) | 1 (Reference) |
| Lymph node involvement | ||||
| NX | 355 (0.8) | 252 (71.0) | 1.08 (0.81–1.45) | 1.13 (0.83–1.55) |
| N0 | 34 687 (80.5) | 22 521 (64.9) | 0.58 (0.54–0.61) | 0.59 (0.55–0.63) |
| N1 | 8025 (18.6) | 5956 (74.2) | 1 (Reference) | 1 (Reference) |
Abbreviations: EN, East North; ES, East South; NOS, not otherwise specified; S, south; WN, West North; WS, West South.