title: Practice patterns in the management of patients with differentiated thyroid cancer in Ontario Canada 2000-2008.
abstract: BACKGROUND
  The extent of treatment for differentiated thyroid cancer remains controversial. The objective of this study was to describe the variations in practice prior to diagnosis and for the first year after diagnosis, including the investigations, the extent of surgery and the use of RAI 131, for all patients with thyroid cancer (TC) treated Jan 1 2000 to Dec 2008 across Ontario Canada.
  
  
  METHODS
  Population-based study of all patients who had a therapeutic surgical procedure for TC based on the data holdings of the Institute of Clinical Investigative Sciences (ICES) linking the Ontario Cancer Registry to the Ontario Health Insurance Plan and to the Canadian Institutes of Health Information. The analysis includes comparisons between health care utilization/geographic regions and between treating specialties. The study population was 12957 patients.
  
  
  RESULTS
  There was a 112% increase in case detection over 9 years. Overall the initial (index) surgery was less-than-total thyroidectomy (LTT) in 37.6% and 63.4% of the patients who had total thyroidectomy (TT) as an index surgery went on to adjuvant RAI, however there was wide variation in all aspects of patient care across the province, between Local Health Networks and between surgical specialties.
  
  
  CONCLUSIONS
  In Ontario, there was wide variation for most aspects of the management of TC and, as the incidence of TC is increasing at least 7% per year in females, these data provide a foundation for future discussions, the provision of health care services and research.
authors: Departments of Otolaryngology and Oncology, Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, 10 Stuart St, 613 533 6000 ext 78535, Kingston K7L 3 N6, ON, Canada. sfh@queensu.ca.
authors: Stephen F
authors: SF
authors: Hall
authors: Jonathan C
authors: JC
authors: Irish
authors: Patti A
authors: PA
authors: Groome
authors: David R
authors: DR
authors: Urbach
mesh_terms: D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D009864:Ontario; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D013965:Thyroidectomy / Q000706:statistics & numerical data*; D014463:Ultrasonography
chemical_list: D007457:Iodine Radioisotopes