Radioactive Iodine; Many patients diagnosed with differentiated thyroid cancer perceive that they have no choice about receiving radioactive iodine (RAI), according to a study published online July 8 in the Journal of Clinical Oncology. Lauren P. Wallner, Ph.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues surveyed 2,632 eligible patients diagnosed with differentiated thyroid cancer from 2014 to 2015.
The analysis include 1,319 patients recommend to receive selective RAI. Patients were question about whether they felt they had a choice to receive RAI; so how strongly their physician recommend it, whether they receive it; also how satisfy they were with their decision. For many patients with differentiate thyroid cancer; hence use of radioactive iodine (RAI) does not improve survival or reduce recurrence risk.
Radioactive iodine for thyroid cancer
Yet there is wide variation in RAI use, emphasizing the importance of understanding patient perspectives regarding RAI decision making. All eligible patients diagnose with thyroid cancer from 2014 to 2015 from the Georgia and Los Angeles SEER registries were surveyed (N = 2,632; response rate, 63%). Patients in whom selective RAI use is recommend were include in this analysis (n = 1,319).
Patients were ask whether they felt like they had a choice to receive RAI (yes or no); so how strongly their physician recommended RAI (5-point Likert-type scale), whether they receive RAI (yes or no); also how satisfy they were with their RAI decision (more [score of 4 or greater] v less). Multivariable, weighted logistic regression with multiple imputation was use to assess; so the associations between patient characteristics and perception of no RAI choice; also between perception of no RAI choice with receipt of RAI and decision satisfaction.
Physicians strongly recommended
The researchers found that most patients (75.9%) received RAI, and 55.8% perceive; so that they did not have a choice about RAI treatment. Patients whose physicians strongly recommend RAI had greater odds of perceiving no RAI choice (adjust odds ratio, 1.56). Patients who perceive not having an RAI choice were more likely to receive RAI and to report lower decision satisfaction (adjusted odds ratios, 2.50 and 2.31, respectively).
“Efforts to promote share decision making and support providers in discussing the risks and benefits of RAI use are warrant to reduce the overtreatment of thyroid cancer,” the authors write. Many patients did not feel they had a choice about whether to receive RAI. Patients who perceive they did not have a choice were more likely to receive RAI and report lower decision satisfaction, suggesting a need for more share decision making to reduce overtreatment.