Access to diagnostic imaging and incidental detection of differentiated thyroid cancer in Ontario: A population-based retrospective cohort study

被引:1
作者
Norwood, Todd A. [1 ,2 ,8 ]
Rosella, Laura C. [1 ,3 ,4 ,5 ]
Buajitti, Emmalin [1 ,3 ]
Lipscombe, Lorraine L. [6 ,7 ]
Stukel, Therese A. [3 ,6 ]
机构
[1] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[2] Canc Care Ontario, Ontario Hlth, Toronto, ON, Canada
[3] ICES, Toronto, ON, Canada
[4] Trillium Hlth Partners, Inst Better Hlth, Toronto, ON, Canada
[5] Univ Toronto, Temerty Fac Med, Lab Med & Pathobiol, Toronto, ON, Canada
[6] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[7] Womens Coll Hosp, Toronto, ON, Canada
[8] Univ Toronto, Hlth Sci Bldg, 155 Coll St, 6th Floor, Toronto, ON M5T 3M7, Canada
基金
加拿大健康研究院;
关键词
Thyroid neoplasms; Incidental findings; Diagnostic imaging; Drivetime analysis; Bayesian hierarchical modeling; OVERDIAGNOSIS; EPIDEMIOLOGY; CARCINOMA; TRENDS; IMPACT; TIME;
D O I
10.1016/j.sste.2022.100540
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Global increases in thyroid cancer incidence (>= 90% differentiated thyroid cancers; DTC) are hypothesized to be related to increased use of pre-diagnostic imaging. These procedures can detect DTC during imaging for con-ditions unrelated to the thyroid (incidental detection). The objectives were to evaluate incidental detection of DTC associated with standardized, regional imaging capacity and drivetime from patient residence to imaging facility (the exposures). We conducted a population-based retrospective cohort study of 32,097 DTC patients in Ontario, 2003-2017. We employed sex-specific spatial Bayesian hierarchical models to evaluate the exposures and examine the adjusted odds of incidental detection by administrative regions. Regional capacities of computed tomography and magnetic resonance imaging scanners are positively associated with incidental detection, but vary by sex. Contrary to hypothesis, drivetimes in urban areas are positively associated with incidental detection. Access to primary care may play a role in several administrative regions with higher adjusted odds of incidental detection.
引用
收藏
页数:9
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