Table 3.
RAI Use for High-Risk Thyroid Cancer
| Patients, n, % |
OR (95% CI) |
|||
|---|---|---|---|---|
| Overall | Treated With RAI | Unadjusted | Adjusted | |
| Hospital characteristics | ||||
| Hospital region | ||||
| EN Central | 1774 (15.1) | 1287 (72.5) | 0.57 (0.38–0.84) | 0.60 (0.41–0.89) |
| ES Central | 624 (5.3) | 426 (68.3) | 0.47 (0.29–0.76) | 0.48 (0.30–0.77) |
| Mid-Atlantic | 2057 (17.5) | 1410 (68.5) | 0.31 (0.20–0.46) | 0.31 (0.21–0.47) |
| Mountain | 669 (5.7) | 495 (74.0) | 0.78 (0.47–1.30) | 0.70 (0.43–1.17) |
| New England | 816 (7.0) | 508 (62.3) | 0.27 (0.17–0.44) | 0.30 (0.19–0.49) |
| Pacific | 1738 (14.8) | 1133 (65.2) | 0.45 (0.30–0.68) | 0.43 (0.29–0.64) |
| S Atlantic | 2154 (18.4) | 1481 (68.8) | 0.43 (0.29–0.63) | 0.42 (0.28–0.62) |
| WS Central | 861 (7.3) | 514 (59.7) | 0.30 (0.19–0.46) | 0.31 (0.20–0.48) |
| WN Central | 1036 (8.8) | 783 (75.6) | 1.0 (Reference) | 1.0 (Reference) |
| Case volume, cases/y | ||||
| Low (≤11) | 1266 (10.8) | 740 (58.5) | 0.48 (0.38–0.61) | 0.53 (0.41–0.67) |
| Medium (12–34) | 3916 (33.4) | 2586 (66.0) | 0.74 (0.60–0.92) | 0.77 (0.62–0.96) |
| High (≥35) | 6547 (55.8) | 4711 (72.0) | 1.0 (Reference) | 1.0 (Reference) |
| Patient characteristics | ||||
| Sex | ||||
| Female | 6995 (59.6) | 4790 (68.5) | 1.05 (0.96–1.15) | 1.06 (0.97–1.17) |
| Male | 4734 (40.4) | 3247 (68.6) | 1.0 (Reference) | 1.0 (Reference) |
| Age, y | ||||
| 45–59 | 6497 (55.4) | 4658 (71.7) | 1.45 (1.33–1.59) | 1.22 (1.09–1.38) |
| ≥60 | 5232 (44.6) | 3379 (64.6) | 1.0 (Reference) | 1.0 (Reference) |
| Charlson-Deyo comorbidity index score | ||||
| 0 | 9434 (80.4) | 6504 (68.9) | 1.17 (1.05–1.31) | 1.06 (0.94–1.19) |
| ≥1 | 2295 (19.6) | 1533 (66.8) | 1.0 (Reference) | 1.0 (Reference) |
| Race/ethnicity | ||||
| Black | 713 (6.1) | 431 (60.4) | 0.79 (0.66–0.96) | 0.92 (0.76–1.12) |
| Other | 1773 (15.1) | 1146 (64.6) | 0.98 (0.86–1.12) | 0.96 (0.83–1.12) |
| White | 9243 (78.8) | 6460 (69.9) | 1.0 (Reference) | 1.0 (Reference) |
| Insurance | ||||
| Insurance, NOS | 1452 (12.6) | 1011 (69.6) | 0.87 (0.74–1.01) | 0.86 (0.73–1.00) |
| Medicaid/uninsured | 731 (6.4) | 471 (64.4) | 0.82 (0.67–0.99) | 0.86 (0.70–1.06) |
| Medicare | 3498 (30.4) | 2214 (63.3) | 0.63 (0.57–0.70) | 0.76 (0.67–0.87) |
| Private/government | 5822 (50.6) | 4235 (72.7) | 1.0 (Reference) | 1 (Reference) |
| Rural-urban continuum | ||||
| Metro population | 9114 (83.8) | 6198 (68.0) | 0.94 (0.81–1.08) | 0.94 (0.81–1.09) |
| Other | 1758 (16.2) | 1250 (71.1) | 1.0 (Reference) | 1.0 (Reference) |
| Tumor characteristics | ||||
| Tumor histology | ||||
| Papillary | 10 001 (85.3) | 6992 (69.9) | 1.60 (1.42–1.80) | 1.21 (1.04–1.40) |
| Follicular/Hurthle cell | 1728 (14.7) | 1045 (60.5) | 1.0 (Reference) | 1.0 (Reference) |
| Lymph node involvement | ||||
| NX | 58 (0.5) | 39 (67.2) | 0.94 (0.50–1.77) | 1.13 (0.56–2.28) |
| N0 | 3749 (32.0) | 2352 (62.7) | 0.65 (0.59–0.71) | 0.78 (0.70–0.88) |
| N1 | 7922 (67.5) | 5646 (71.3) | 1.0 (Reference) | 1.0 (Reference) |
| Distant metastases | ||||
| M0 | 11 283 (96.2) | 7769 (68.9) | 1.42 (1.14–1.77) | 1.18 (0.93–1.49) |
| M1 | 446 (3.8) | 268 (60.1) | 1.0 (Reference) | 1.0 (Reference) |
Abbreviations: EN, East North; ES, East South; M1, distant metastases present; M0, distant metastases absent; NOS, not otherwise specified; S, south; WN, West North; WS, West South.