Demographic and socioeconomic factors predictive of compliance with American Thyroid Association guidelines for the treatment for advanced papillary thyroid carcinoma

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. CONCLUSION: 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.