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The role of standard radioactive iodine therapy for the growing number of patients with well-differentiated thyroid cancer is debated. Arguments in favor of iodine therapy after total thyroidectomy include elimination of micrometastatic disease and improved ability to follow the tumor marker thyroglobulin. Arguments against such treatment cite its cost, toxicity, and low potential benefit.
To identify recent changes in the use of radioactive iodine therapy in this setting, investigators assessed 189,219 patients in the U.S. National Cancer database who were treated for well-differentiated thyroid cancer at 981 hospitals from 1990 through 2008. All patients had undergone thyroidectomy and had papillary, follicular, or Hürthle-cell tumor histo…