Many patients diagnosed with differentiated thyroid cancer perceive that they have no choice about receiving radioactive iodine (RAI), according to a study published online 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 included 1,319 patients recommended to receive selective RAI. Patients were questioned about whether they felt they had a choice to receive RAI, how strongly their physician recommended it, whether they received it, and how satisfied they were with their decision.

The researchers found that most patients (75.9 percent) received RAI, and 55.8 percent perceived that they did not have a choice about RAI treatment. Patients whose physicians strongly recommended RAI had greater odds of perceiving no RAI choice (adjusted odds ratio, 1.56). Patients who perceived 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 shared decision making and support providers in discussing the risks and benefits of RAI use are warranted to reduce the overtreatment of thyroid cancer," the authors write.

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