title: Demographic and socioeconomic factors predictive of compliance with American Thyroid Association guidelines for the treatment for advanced papillary thyroid carcinoma.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Wenaas
authors.affiliation: Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Celeste Z
authors.initials: CZ
authors.lastname: Nagy
authors.affiliation: Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Yin
authors.initials: Y
authors.lastname: Yiu
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.affiliation: Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Horter
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Jose P
authors.initials: JP
authors.lastname: Zevallos
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D002277:Carcinoma / Q000188:drug therapy* / Q000208:ethnology*; D002291:Carcinoma, Papillary; D004704:Endocrinology; D005260:Female; D017408:Guidelines as Topic; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012955:Societies, Medical; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000208:ethnology*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D007457:Iodine Radioisotopes
keywords: American Thyroid Association (ATA) guidelines; disparities; papillary thyroid carcinoma; socioeconomic status; thyroid cancer