Grant Number:	1R01CA201198-01A1 Interpret this number
Primary Investigator:	Haymart, Megan
Organization:	University Of Michigan At Ann Arbor
Project Title:	Treatment Decision Making in Low-Risk Thyroid Cancer
Fiscal Year:	2016

Project Summary In the past 30 years, the incidence of thyroid cancer has tripled. The majority of the rise in thyroid cancer incidence is attributed to an increase in low-risk, well-differentiated thyroid cancer, a disease that has a 10-year mortality close to zero. Our previous work suggests that patients with low-risk thyroid cancer are at risk for overtreatment, defined as the use of surgical and medical interventions in the absence of a clear survival benefit. The overtreatment of thyroid cancer has inherent costs, both to patient health and to society. The reason for the intensive management and potential overtreatment of low-risk thyroid cancer remains unclear. By using SEER-linked patient and physician surveys, we plan to understand the treatment decision making in low-risk thyroid cancer. We hypothesize that knowledge and attitudes influence decision making. Specifically, we anticipate that lack of knowledge of risks of death, recurrence and treatment complications is associated with treatment that is more intensive. In addition, we postulate that a general preference for active treatment will also be associated with more intensive cancer treatment. Although both patient and physician perceptions of treatment need (i.e., knowledge and attitudes) likely contribute to treatment intensity, we anticipate that the primary driver will be physicians, even after controlling for their patients' perceptions. This study will serve as the foundation for future intervention studies. By identifying the specific role of physician and patient knowledge and attitudes toward thyroid cancer treatment, we will be able to create tailored educational interventions to personalize surgical and medical care for thyroid cancer patients, thus minimizing overtreatment and its inherent risks and costs. As the rising incidence, low mortality, and pattern of intensive treatment make thyroid cancer arguably the best cancer model for overtreatment, this proposed study will also serve as a model to understand overtreatment in other malignancies.




Physician specialties involved in thyroid cancer diagnosis and treatment: Implications for improving healthcare disparities.
Authors: Radhakrishnan A. , Reyes-Gastelum D. , Abrahamse P. , Gay B. , Hawley S.T. , Wallner L.P. , Chen D.W. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2021-10-26 00:00:00.0; , .
EPub date: 2021-10-26 00:00:00.0.
PMID: 34718629
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Change in worry over time among Hispanic women with thyroid cancer.
Authors: Jackson Levin N. , Zhang A. , Reyes-Gastelum D. , Chen D.W. , Hamilton A.S. , Zebrack B. , Haymart M.R. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2021-10-11 00:00:00.0; , .
EPub date: 2021-10-11 00:00:00.0.
PMID: 34633638
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Breaking Down or Waking Up? Psychological Distress and Sleep Disturbance in Patients With Thyroid Nodules and Cancer.
Authors: Pitt S.C. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2021-09-27 00:00:00.0; 106(10), p. e4278-e4280.
PMID: 33982121
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Thyroid Hormone Therapy and Incident Stroke.
Authors: Papaleontiou M. , Levine D.A. , Reyes-Gastelum D. , Hawley S.T. , Banerjee M. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2021-09-27 00:00:00.0; 106(10), p. e3890-e3900.
PMID: 34137866
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Surgeons' Attitudes on Total Thyroidectomy vs Lobectomy for Management of Papillary Thyroid Microcarcinoma.
Authors: Rosko A.J. , Gay B.L. , Reyes-Gastelum D. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Jama Otolaryngology-- Head & Neck Surgery, 2021-07-01 00:00:00.0; 147(7), p. 667-669.
PMID: 33885723
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Unmet Information Needs Among Hispanic Women with Thyroid Cancer.
Authors: Chen D.W. , Reyes-Gastelum D. , Hawley S.T. , Wallner L.P. , Hamilton A.S. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2021-06-16 00:00:00.0; 106(7), p. e2680-e2687.
PMID: 33660770
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Multilevel Factors Associated With More Intensive Use of Radioactive Iodine for Low-Risk Thyroid Cancer.
Authors: Wallner L.P. , Banerjee M. , Reyes-Gastelum D. , Hamilton A.S. , Ward K.C. , Lubitz C. , Hawley S.T. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2021-05-13 00:00:00.0; 106(6), p. e2402-e2412.
PMID: 33687063
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TSH Suppression for Papillary Thyroid Cancer: A Physician Survey Study.
Authors: Papaleontiou M. , Chen D. , Banerjee M. , Reyes-Gastelum D. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Thyroid : Official Journal Of The American Thyroid Association, 2021-03-27 00:00:00.0; , .
EPub date: 2021-03-27 00:00:00.0.
PMID: 33779292
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Physician Confidence in Neck Ultrasonography for Surveillance of Differentiated Thyroid Cancer Recurrence.
Authors: Kovatch K.J. , Reyes-Gastelum D. , Sipos J.A. , Caoili E.M. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Jama Otolaryngology-- Head & Neck Surgery, 2020-12-23 00:00:00.0; , .
EPub date: 2020-12-23 00:00:00.0.
PMID: 33355635
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Barriers to the Use of Active Surveillance for Thyroid Cancer: Results of a Physician Survey.
Authors: Hughes D.T. , Reyes-Gastelum D. , Ward K.C. , Hamilton A.S. , Haymart M.R. .
Source: Annals Of Surgery, 2020-10-16 00:00:00.0; , .
EPub date: 2020-10-16 00:00:00.0.
PMID: 33074908
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Physician-Reported Misuse of Thyroid Ultrasonography.
Authors: Chen D.W. , Reyes-Gastelum D. , Radhakrishnan A. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Jama Surgery, 2020-10-01 00:00:00.0; 155(10), p. 984-986.
PMID: 32804996
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Financial Hardship Among Hispanic Women with Thyroid Cancer.
Authors: Chen D.W. , Reyes-Gastelum D. , Veenstra C.M. , Hamilton A.S. , Banerjee M. , Haymart M.R. .
Source: Thyroid : Official Journal Of The American Thyroid Association, 2020-09-22 00:00:00.0; , .
EPub date: 2020-09-22 00:00:00.0.
PMID: 32838705
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Physician management of thyroid cancer patients' worry.
Authors: Papaleontiou M. , Zebrack B. , Reyes-Gastelum D. , Rosko A.J. , Hawley S.T. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2020-09-16 00:00:00.0; , .
EPub date: 2020-09-16 00:00:00.0.
PMID: 32939685
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Patient Report of Recurrent and Persistent Thyroid Cancer.
Authors: Papaleontiou M. , Evron J.M. , Esfandiari N.H. , Reyes-Gastelum D. , Ward K.C. , Hamilton A.S. , Worden F. , Haymart M.R. .
Source: Thyroid : Official Journal Of The American Thyroid Association, 2020 09; 30(9), p. 1297-1305.
EPub date: 2020-04-16 00:00:00.0.
PMID: 32183609
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Primary Care Provider Involvement in Thyroid Cancer Survivorship Care.
Authors: Radhakrishnan A. , Reyes-Gastelum D. , Gay B. , Hawley S.T. , Hamilton A.S. , Ward K.C. , Wallner L.P. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2020-09-01 00:00:00.0; 105(9), .
PMID: 32639557
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Thyroid dysfunction following pregnancy and implications for breastfeeding.
Authors: Amino N. , Arata N. .
Source: Best Practice & Research. Clinical Endocrinology & Metabolism, 2020 07; 34(4), p. 101438.
EPub date: 2020-06-20 00:00:00.0.
PMID: 32651061
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The Relationship Between Imaging and Thyroid Cancer Diagnosis and Survival.
Authors: Haymart M.R. , Reyes-Gastelum D. , Caoili E. , Norton E.C. , Banerjee M. .
Source: The Oncologist, 2020-04-23 00:00:00.0; , .
EPub date: 2020-04-23 00:00:00.0.
PMID: 32329106
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Energy level and fatigue after surgery for thyroid cancer: A population-based study of patient-reported outcomes.
Authors: Hughes D.T. , Reyes-Gastelum D. , Kovatch K.J. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Surgery, 2020 Jan; 167(1), p. 102-109.
EPub date: 2019-09-30 00:00:00.0.
PMID: 31582311
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Disparities in risk perception of thyroid cancer recurrence and death.
Authors: Chen D.W. , Reyes-Gastelum D. , Wallner L.P. , Papaleontiou M. , Hamilton A.S. , Ward K.C. , Hawley S.T. , Zikmund-Fisher B.J. , Haymart M.R. .
Source: Cancer, 2019-12-23 00:00:00.0; , .
EPub date: 2019-12-23 00:00:00.0.
PMID: 31869452
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Factors Associated With Diagnosis and Treatment of Thyroid Microcarcinomas.
Authors: Esfandiari N.H. , Hughes D.T. , Reyes-Gastelum D. , Ward K.C. , Hamilton A.S. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2019-12-01 00:00:00.0; 104(12), p. 6060-6068.
PMID: 31415089
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Thyroid nodules and cancer during pregnancy, post-partum and preconception planning: Addressing the uncertainties and challenges.
Authors: Papaleontiou M. , Haymart M.R. .
Source: Best Practice & Research. Clinical Endocrinology & Metabolism, 2019-11-22 00:00:00.0; , p. 101363.
EPub date: 2019-11-22 00:00:00.0.
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Role of Patient Maximizing-Minimizing Preferences in Thyroid Cancer Surveillance.
Authors: Evron J.M. , Reyes-Gastelum D. , Banerjee M. , Scherer L.D. , Wallner L.P. , Hamilton A.S. , Ward K.C. , Hawley S.T. , Zikmund-Fisher B.J. , Haymart M.R. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2019-11-10 00:00:00.0; 37(32), p. 3042-3049.
EPub date: 2019-10-01 00:00:00.0.
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Patient Requests for Tests and Treatments Impact Physician Management of Hypothyroidism.
Authors: Esfandiari N.H. , Reyes-Gastelum D. , Hawley S.T. , Haymart M.R. , Papaleontiou M. .
Source: Thyroid : Official Journal Of The American Thyroid Association, 2019 11; 29(11), p. 1536-1544.
EPub date: 2019-10-10 00:00:00.0.
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Risk of Osteoporosis and Fractures in Patients with Thyroid Cancer: A Case-Control Study in U.S. Veterans.
Authors: Papaleontiou M. , Banerjee M. , Reyes-Gastelum D. , Hawley S.T. , Haymart M.R. .
Source: The Oncologist, 2019 09; 24(9), p. 1166-1173.
EPub date: 2019-06-04 00:00:00.0.
PMID: 31164453
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Assessment of Voice Outcomes Following Surgery for Thyroid Cancer.
Authors: Kovatch K.J. , Reyes-Gastelum D. , Hughes D.T. , Hamilton A.S. , Ward K.C. , Haymart M.R. .
Source: Jama Otolaryngology-- Head & Neck Surgery, 2019-09-01 00:00:00.0; 145(9), p. 823-829.
PMID: 31318375
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Patient-Perceived Lack of Choice in Receipt of Radioactive Iodine for Treatment of Differentiated Thyroid Cancer.
Authors: Wallner L.P. , Reyes-Gastelum D. , Hamilton A.S. , Ward K.C. , Hawley S.T. , Haymart M.R. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2019-08-20 00:00:00.0; 37(24), p. 2152-2161.
EPub date: 2019-07-08 00:00:00.0.
PMID: 31283406
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Worry in Thyroid Cancer Survivors with a Favorable Prognosis.
Authors: Papaleontiou M. , Reyes-Gastelum D. , Gay B.L. , Ward K.C. , Hamilton A.S. , Hawley S.T. , Haymart M.R. .
Source: Thyroid : Official Journal Of The American Thyroid Association, 2019 08; 29(8), p. 1080-1088.
EPub date: 2019-07-25 00:00:00.0.
PMID: 31232194
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Treatment-Free Survival in Patients With Differentiated Thyroid Cancer.
Authors: Banerjee M. , Reyes-Gastelum D. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2018-07-01 00:00:00.0; 103(7), p. 2720-2727.
PMID: 29788217
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Active Surveillance for Low-Risk Cancers - A Viable Solution to Overtreatment?
Authors: Haymart M.R. , Miller D.C. , Hawley S.T. .
Source: The New England Journal Of Medicine, 2017-07-20 00:00:00.0; 377(3), p. 203-206.
PMID: 28723330
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REFERRAL OF OLDER THYROID CANCER PATIENTS TO A HIGH-VOLUME SURGEON: RESULTS OF A MULTIDISCIPLINARY PHYSICIAN SURVEY.
Authors: Papaleontiou M. , Gauger P.G. , Haymart M.R. .
Source: Endocrine Practice : Official Journal Of The American College Of Endocrinology And The American Association Of Clinical Endocrinologists, 2017 Jul; 23(7), p. 808-815.
EPub date: 2017-05-23 00:00:00.0.
PMID: 28534681
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Controversies in the Management of Low-Risk Differentiated Thyroid Cancer.
Authors: Haymart M.R. , Esfandiari N.H. , Stang M.T. , Sosa J.A. .
Source: Endocrine Reviews, 2017-06-19 00:00:00.0; , .
EPub date: 2017-06-19 00:00:00.0.
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Population-Based Assessment of Complications following Surgery for Thyroid Cancer.
Authors: Papaleontiou M. , Hughes D.T. , Guo C. , Banerjee M. , Haymart M.R. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2017-04-28 00:00:00.0; , .
EPub date: 2017-04-28 00:00:00.0.
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Skeletal Complications and Mortality in Thyroid Cancer: A Population-Based Study.
Authors: Choksi P. , Papaleontiou M. , Guo C. , Worden F. , Banerjee M. , Haymart M. .
Source: The Journal Of Clinical Endocrinology And Metabolism, 2017-04-01 00:00:00.0; 102(4), p. 1254-1260.
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How Much Should Thyroid Cancer Impact Plans for Pregnancy?
Authors: Haymart M.R. , Pearce E.N. .
Source: Thyroid : Official Journal Of The American Thyroid Association, 2017 03; 27(3), p. 312-314.
EPub date: 2017-01-12 00:00:00.0.
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Inappropriate Use Of Suppressive Doses Of Thyroid Hormone In Thyroid Nodule Management: Results From A Nationwide Survey
Authors: Papaleontiou M. , Haymart M.R. .
Source: Endocrine Practice : Official Journal Of The American College Of Endocrinology And The American Association Of Clinical Endocrinologists, 2016 Nov; 22(11), p. 1358-1360.
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THE IMPACT OF AGE IN THE MANAGEMENT OF HYPOTHYROIDISM: RESULTS OF A NATIONWIDE SURVEY.
Authors: Papaleontiou M. , Gay B.L. , Esfandiari N.H. , Hawley S.T. , Haymart M.R. .
Source: Endocrine Practice : Official Journal Of The American College Of Endocrinology And The American Association Of Clinical Endocrinologists, 2016 Jun; 22(6), p. 708-15.
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