title: Adjuvant radioactive iodine use among differentiated thyroid cancer patients in the military health system.
abstract: OBJECTIVE
  Adjuvant radioactive iodine (RAI) for the treatment of differentiated thyroid cancer has been associated with better prognosis, but no consensus has been reached on the best practices for RAI. Limited data on RAI use and factors associated with the receipt of postoperative RAI in the general population are available and, to our knowledge, no data on RAI use among the U.S. Department of Defense (DoD) beneficiaries.
  
  
  METHODS
  Among 3,002 beneficiaries with differentiated thyroid cancer, who underwent total/near-total thyroidectomy between 1998 and 2007, logistic regression identified factors associated with RAI and examined effect modification by age and tumor size.
  
  
  RESULTS
  Fifty-two percent of patients received RAI. Receipt of RAI was more likely among beneficiaries who were diagnosed between 2004 and 2007, active duty members, had indirect care, and more advanced disease, and less likely among those affiliated with the Air Force or had unknown medical coverage. In addition, receipt of RAI significantly varied by tumor size among patients with regional lymph node metastasis.
  
  
  CONCLUSIONS
  Among DoD beneficiaries, adjuvant RAI use was associated with clinical and nonclinical factors. Although evidence of effect modification between the recipient of RAI by tumor size was apparent, future research with a larger sample size is warranted to confirm results of this study.
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, 11300 Rockville Pike, Suite 1215, Rockville, MD 20852.
authors.forename: Abegail A
authors.initials: AA
authors.lastname: Gill
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, 11300 Rockville Pike, Suite 1215, Rockville, MD 20852.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Enewold
authors.affiliation: National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850.
authors.forename: Shelia H
authors.initials: SH
authors.lastname: Zahm
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, 11300 Rockville Pike, Suite 1215, Rockville, MD 20852.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Shriver
authors.affiliation: Inova Education and Research Center, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042.
authors.forename: Li
authors.initials: L
authors.lastname: Zheng
authors.affiliation: National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
authors.affiliation: John P. Murtha Cancer Center, Walter Reed National Military Medical Center, 11300 Rockville Pike, Suite 1215, Rockville, MD 20852.
authors.forename: Kangmin
authors.initials: K
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012042:Registries; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D007457:Iodine Radioisotopes