Brooke Nickel|Kirsten Howard|Juan P. Brito|Alexandra Barratt|Ray Moynihan|Kirsten McCaffery
Association of Preferences for Papillary Thyroid Cancer Treatment With Disease Terminology
University of Sydney|Sydney Local Health District|University of Sydney|Sydney Local Health District|Mayo Clinic in Florida|University of Sydney|Sydney Local Health District|University of Sydney|Bond University|University of Sydney|Sydney Local Health District
given recent evidence overdiagnosis overtreatment small papillary thyroid cancers ptcs lowrisk cancers strategies needed help patients consider less invasive treatment optionsto determine factors influence treatment preferences patients ptc tradeoffs treatment factors people willing accept understand terminology influences preferences benefitharm tradeoffspreferences ptc treatment evaluated using discrete choice experiment dce conducted webbased survey using existing public online research panel participants randomized receive 1 2 frames information based terminology used describe condition cancer lesion participants chose 3 treatment options ptc thyroidectomy hemithyroidectomy active surveillance analyses conducted using mixed logit modelthe main outcome variable treatment preference attributes treatment options sociodemographic characteristics explanatory variablesthe dce completed 2054 participants 993 483 men 1061 517 women mean sd age 460 165 years history thyroid cancer participants preferred options less frequent followup lower outofpocket costs lower chances voice calcium level problems lower risk developing invasive thyroid cancer dying thyroid cancer trading benefits harms participants willing accept higher number extra patients experiencing adverse effects avoid thyroid cancer death condition described cancer compared lesion specifically participants condition described cancer willing accept patients requiring lifelong medication mean 273 95 ci 207339 vs mean 98 95 ci 66131 experiencing calcium problems mean 110 95 ci 77144 vs mean 56 95 ci 5558 fatigue mean 958 95 ci 6911224 vs mean 469 95 ci 375564 cancer lesion terminology health literacy consistently associated preferences treatment options lower health literacy significantly lower preference less invasive treatment optionsthis study makes important contribution understanding attributes treatment options terminology patient characteristics particular health literacy influence treatment decision making ptc result increasing evidence indolent nature ptc lowrisk cancers strategies deal potential overtreatment critically neededaustralian new zealand clinical trials registry actrn12617000066381