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Second, it is possible that the administration of RAI may be missed by SEER registrars, leading to under counting. Although RAI is recorded reliably in the first postoperative year, patients are not followed specifically for RAI status after 1 year. In both instances, these possible misclassification errors would have conservative effects on our analyses, in that they would dilute the trend in RAI use and would attenuate the excess risk of SPM in the RAI-positive cohort. Thyroid cancer incidence and RAI use were regressed over time using linear and polynomial least-squares regression models. SIR confidence intervals (CIs) were calculated using the Byar approximation to Poisson distribution.18 To determine changes in the risk of SPM over time, the trend in SIR was analyzed http://www.selleckchem.com/products/SB-431542.html across 4 time periods, binned by year of diagnosis (1973-81, 1982-89, 1990-98, and 1999-2006). Overall survival rates were calculated using the Kaplan-Meier method. SIR and EAR values were calculated using the SEER*Stat software package (release 6.6.2, March 2010; NCI Cancer Statistics Branch, Bethesda, Md). Additional statistical analyses were performed using the SAS statistical software package (version 9.2, March 2008; SAS Institute Inc., Cary, NC). Over the past 3 decades, there has been a dramatic increase in the incidence of WDTC, from http://www.selleck.cn/products/ipi-145-ink1197.html 3.5 per 100,000 in 1973 to 11.4 per 100,000 in 2007. Thyroid tumor size has been recorded since 1983. In 1983, low-risk WDTC (intrathyroid T1N0M0 tumors http://www.selleckchem.com/products/byl719.html data indicated that 38.5% of all tumors and 27.2% of microcarcinomas were multicentric. Despite the increasing proportion of low-risk tumors, the use of RAI for WDTC has increased dramatically since 1973. Between 1973 and 2006, RAI was received by 14,589 patients. The percentage of patients with WDTC who received RAI as part of the first course of therapy overall has increased from 6.1% to 48.7% (P