evekhm/cms_iom_500 huggingface dataset:
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
CMS National Coverage PolicyTitle XVIII of the Social Security Act, 1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary.42 CFR 410.32(a) Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: ConditionsCMS Internet-Only Manual, Pub. 100-02, Medicare Policy Manual, Chapter 15, 80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests, 80.1.1 Certification ChangesCoverage Indications, Limitations, and/or Medical NecessityThis is a coverage policy for gene expression profile tests that assess risk or predict therapeutic response in men who have an established diagnosis of castration resistant or metastatic prostate cancer.Such testing is considered reasonable and necessary to help guide treatment decisions in men with prostate cancer and a life expectancy such that they are candidates for prostate cancer treatment according to the most recent nationally recognized guidelines at the time of testing or based on FDA labelling of drugs and biologics available as potential treatment options.The scope of this policy includes gene expression profile tests regardless of methodology. It is exclusive of targeted and comprehensive genomic profiles (CGP) by next generation sequencing (NGS) and single biomarker expression analyses.Coverage criteria:1. BOTH of the following criteria must be met:The beneficiary is being actively managed for castration resistant or metastatic (hormone sensitive or castration resistant) prostate cancer.The beneficiary is within the population and has the indication for which the test was developed and validated.2. At least 1 of the following criteria are met:The patient is a candidate for more than one management option, which could be considered to have varied, or increasing/decreasing levels of intensity based on a nationally recognized consensus guideline, and the physician and patient must decide among these treatments ORThe patient is a candidate for more than one management option, and the test has shown that it predicts response to a specific therapy among accepted therapy options based on nationally recognized consensus guidelines and/or FDA labelling.3. The patient has not been tested with the same or similar test for prostate cancer.4. The patient has not received pelvic radiation or androgen deprivation therapy (ADT) prior to the biopsy or prostate resection specimen on which the test will be performed.
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
The only exception to this is for men who are nave to secondary systemic therapies (that could be given after ADT monotherapy) AND at least 1 of the following is true:a. They do not have other standard-of-care drug-targetable gene alterations to guide systemic therapy, as defined in nationally recognized guidelines ORb. They have other standard-of-care drug-targetable gene alterations to guide systemic therapy, as defined in nationally recognized guidelines but they are not eligible for those therapies for another reason.The test demonstrates analytical validity (AV), clinical validity (CV) and clinical utility (CU), establishing a clear and significant biological/ molecular basis for stratifying patients and subsequently selecting (either positively or negatively) a clinical management in a clearly defined population.Clinical validity of any analytes (or expression profiles) measured must be established through a study published in the peer-reviewed literature for the intended use of the test in the intended population.If the test relies on an algorithm, the algorithm must be validated in a cohort that is not a development cohort for the algorithm.Testing must be performed according to Clinical Laboratory Improvement Amendments (CLIA) and/or Food and Drug Administration (FDA) regulations in an accredited laboratory.The lab providing the test is responsible for clearly indicating to treating physicians the population and indication(s) for test use.The test successfully completes a Molecular Diagnostic Services Program (MolDX) Technical Assessment that ensures that AV, CV, and CU criteria set in this policy are met to establish the test as Reasonable and Necessary.Genomic expression profile tests that demonstrate equivalent or superior analytical and clinical validity to those covered by this contractor will be considered reasonable and necessary for the same indications.General InformationAssociated InformationN/ASources of InformationN/ABibliography
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023.CA Cancer J Clin. 2023;73(1):17-48. doi:10.3322/caac.21763Basourakos SP, Gulati R, Vince RA Jr, et al. Harm-to-benefit of three decades of prostate cancer screening in black men.NEJM Evid. 2022;1(6).Awasthi S, Grass GD, Torres-Roca J, et al. Genomic testing in localized prostate cancer can identify subsets of African Americans with aggressive disease.J Natl Cancer Inst. 2022;114(12):1656-1664. doi:10.1093/jnci/djac162Siegel DA, O'Neil ME, Richards TB, Dowling NF, Weir HK. Prostate cancer incidence and survival, by stage and race/ethnicity - United States, 2001-2017.MMWR Morb Mortal Wkly Rep. 2020;69(41):1473-1480. doi:10.15585/mmwr.mm6941a1Dai C, Heemers H, Sharifi N. Androgen signaling in prostate cancer.Cold Spring Harb Perspect Med. 2017;7(9):a030452.Sweeney CJ, Chen YH, Carducci M, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer.N Engl J Med. 2015;373(8):737-746. doi:10.1056/NEJMoa1503747James ND, Sydes MR, Clarke NW, et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial.Lancet. 2016;387(10024):1163-1177. doi:10.1016/S0140-6736(15)01037-5
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Fizazi K, Tran N, Fein L, et al. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer.N Engl J Med. 2017;377(4):352-360. doi:10.1056/NEJMoa1704174Beer TM, Armstrong AJ, Rathkopf DE, et al. Enzalutamide in metastatic prostate cancer before chemotherapy.N Engl J Med. 2014;371(5):424-433. doi:10.1056/NEJMoa1405095Armstrong AJ, Szmulewitz RZ, Petrylak DP, et al. ARCHES: a randomized, phase III study of androgen deprivation therapy with enzalutamide or placebo in men with metastatic hormone-sensitive prostate cancer.J Clin Oncol. 2019;37(32):2974-2986. doi:10.1200/JCO.19.00799NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Prostate Cancer. Version 1.2023.Virgo KS, Rumble RB, de Wit R, et al. Initial management of noncastrate advanced, recurrent, or metastatic prostate cancer: ASCO guideline update.J Clin Oncol. 2021;39(11):1274-1305. doi:10.1200/JCO.20.03256Lowrance W, Dreicer R, Jarrard DF, et al. Updates to advanced prostate cancer: AUA/SUO guideline (2023).J Urol. 2023;209(6):1082-1090. doi:10.1097/JU.0000000000003452Cancer Genome Atlas Research Network. The molecular taxonomy of primary prostate cancer.Cell. 2015;163(4):1011-1025. doi:10.1016/j.cell.2015.10.025Robinson D, Van Allen EM, Wu YM, et al. Integrative clinical genomics of advanced prostate cancer.Cell. 2015;161(5):1215-1228. doi:10.1016/j.cell.2015.05.001
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Ryan S, Jenkins MA, Win AK. Risk of prostate cancer in Lynch syndrome: a systematic review and meta-analysis.Cancer Epidemiol Biomarkers Prev. 2014;23(3):437-449. doi:10.1158/1055-9965.EPI-13-1165Castro E, Goh C, Olmos D, et al. Germline BRCA mutations are associated with higher risk of nodal involvement, distant metastasis, and poor survival outcomes in prostate cancer.J Clin Oncol. 2013;31(14):1748-1757. doi:10.1200/JCO.2012.43.1882Messina C, Cattrini C, Soldato D, et al. BRCA mutations in prostate cancer: prognostic and predictive implications.J Oncol. 2020;2020:4986365. doi:10.1155/2020/4986365de Bono J, Mateo J, Fizazi K, et al. Olaparib for metastatic castration-resistant prostate cancer.N Engl J Med. 2020;382(22):2091-2102. doi:10.1056/NEJMoa1911440Gillette CM, Yette GA, Cramer SD, Graham LS. Management of advanced prostate cancer in the precision oncology era.Cancers (Basel). 2023;15(9):2552. doi:10.3390/cancers15092552Pritchard CC, Mateo J, Walsh MF, et al. Inherited DNA-repair gene mutations in men with metastatic prostate cancer.N Engl J Med. 2016;375(5):443-453. doi:10.1056/NEJMoa1603144Erho N, Crisan A, Vergara IA, et al. Discovery and validation of a prostate cancer genomic classifier that predicts early metastasis following radical prostatectomy.PLoS One. 2013;8(6):e66855.
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Kim HL, Li P, Huang HC, et al. Validation of the Decipher Test for predicting adverse pathology in candidates for prostate cancer active surveillance.Prostate Cancer Prostatic Dis. 2019;22(3):399-405. doi:10.1038/s41391-018-0101-6Spratt DE, Yousefi K, Deheshi S, et al. Individual patient-level meta-analysis of the performance of the decipher genomic classifier in high-risk men after prostatectomy to predict development of metastatic disease.J Clin Oncol. 2017;35(18):1991-1998.Srlie T, Perou CM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications.Proc Natl Acad Sci U S A. 2001;98(19):10869-10874. doi:10.1073/pnas.191367098Wallden B, Storhoff J, Nielsen T, et al. Development and verification of the PAM50-based Prosigna breast cancer gene signature assay.BMC Med Genomics. 2015;8:54.Parker JS, Mullins M, Cheang MC, et al. Supervised risk predictor of breast cancer based on intrinsic subtypes.J Clin Oncol. 2009;27(8):1160-1167. doi:10.1200/JCO.2008.18.1370Choi W, Porten S, Kim S, et al. Identification of distinct basal and luminal subtypes of muscle-invasive bladder cancer with different sensitivities to frontline chemotherapy.Cancer Cell. 2014;25(2):152-165. doi:10.1016/j.ccr.2014.01.009Zhao SG, Chang SL, Erho N, et al. Associations of luminal and basal subtyping of prostate cancer with prognosis and response to androgen deprivation therapy.JAMA Oncol. 2017;3(12):1663-1672. doi:10.1001/jamaoncol.2017.0751
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Zhao SG, Chen WS, Das R, et al. Clinical and genomic implications of luminal and basal subtypes across carcinomas.Clin Cancer Res. 2019;25(8):2450-2457. doi:10.1158/1078-0432.CCR-18-3121Spratt DE, Alshalalfa M, Fishbane N, et al. Transcriptomic heterogeneity of androgen receptor activity defines ade novolow ar-active subclass in treatment nave primary prostate cancer.Clin Cancer Res. 2019;25(22):6721-6730. doi:10.1158/1078-0432.CCR-19-1587Kyriakopoulos CE, Chen YH, Carducci MA, et al. Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial.J Clin Oncol. 2018;36(11):1080-1087. doi:10.1200/JCO.2017.75.3657Hamid AA, Huang HC, Wang V, et al. Transcriptional profiling of primary prostate tumor in metastatic hormone-sensitive prostate cancer and association with clinical outcomes: correlative analysis of the E3805 CHAARTED trial.Ann Oncol. 2021;32(9):1157-1166. doi:10.1016/j.annonc.2021.06.003Smith MR, Saad F, Chowdhury S, et al. Apalutamide treatment and metastasis-free survival in prostate cancer.N Engl J Med. 2018;378(15):1408-1418. doi:10.1056/NEJMoa1715546Feng FY, Thomas S, Saad F, et al. Association of molecular subtypes with differential outcome to apalutamide treatment in nonmetastatic castration-resistant prostate cancer.JAMA Oncol. 2021;7(7):1005-1014. doi:10.1001/jamaoncol.2021.1463
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Aggarwal R, Rydzewski NR, Zhang L, et al. Prognosis associated with luminal and basal subtypes of metastatic prostate cancer.JAMA Oncol. 2021;7(11):1644-1652. doi:10.1001/jamaoncol.2021.3987Alumkal JJ, Sun D, Lu E, et al. Transcriptional profiling identifies an androgen receptor activity-low, stemness program associated with enzalutamide resistance.Proc Natl Acad Sci U S A. 2020;117(22):12315-12323. doi:10.1073/pnas.1922207117Zhang D, Park D, Zhong Y, et al. Stem cell and neurogenic gene-expression profiles link prostate basal cells to aggressive prostate cancer.Nat Commun. 2016;7:10798.Coleman IM, DeSarkar N, Morrissey C, et al. Therapeutic implications for intrinsic phenotype classification of metastatic castration-resistant prostate cancer.Clin Cancer Res. 2022;28(14):3127-3140. doi:10.1158/1078-0432.CCR-21-4289Labrecque MP, Coleman IM, Brown LG, et al. Molecular profiling stratifies diverse phenotypes of treatment-refractory metastatic castration-resistant prostate cancer.J Clin Invest. 2019;129(10):4492-4505.Beltran H, Prandi D, Mosquera JM, et al. Divergent clonal evolution of castration-resistant neuroendocrine prostate cancer.Nat Med. 2016;22(3):298-305. doi:10.1038/nm.4045Kumar A, Coleman I, Morrissey C, et al. Substantial interindividual and limited intraindividual genomic diversity among tumors from men with metastatic prostate cancer.Nat Med. 2016;22(4):369-378. doi:10.1038/nm.4053
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Aryee MJ, Liu W, Engelmann JC, et al. DNA methylation alterations exhibit intraindividual stability and interindividual heterogeneity in prostate cancer metastases.Sci Transl Med. 2013;5(169):169ra10. doi:10.1126/scitranslmed.3005211Liu W, Laitinen S, Khan S, et al. Copy number analysis indicates monoclonal origin of lethal metastatic prostate.Nat Med. 2009;15(5):559-565. doi:10.1038/nm.1944Sathianathen NJ, Philippou YA, Kuntz GM, et al. Taxane-based chemohormonal therapy for metastatic hormone-sensitive prostate cancer.Cochrane Database Syst Rev. 2018;10(10):CD012816.Nowakowska MK, Ortega RM, Wehner MR, Nead KT. Association of second-generation antiandrogens with cognitive and functional toxic effects in randomized clinical trials: a systematic review and meta-analysis [published online ahead of print, 2023 May 25].JAMA Oncol. 2023;e230998. doi:10.1001/jamaoncol.2023.0998Fizazi K, Foulon S, Carles J, et al. Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 22 factorial design.Lancet. 2022;399(10336):1695-1707. doi:10.1016/S0140-6736(22)00367-1Smith MR, Hussain M, Saad F, et al. Darolutamide and survival in metastatic, hormone-sensitive prostate cancer.N Engl J Med. 2022;386(12):1132-1142. doi:10.1056/NEJMoa2119115
Proposed LCD - MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39648)
Riaz IB, Naqvi SAA, He H, et al. First-line systemic treatment options for metastatic castration-sensitive prostate cancer: a living systematic review and network meta-analysis.JAMA Oncol. 2023;9(5):635-645. doi:10.1001/jamaoncol.2022.7762Hoeh B, Garcia CC, Wenzel M, et al. Triplet or doublet therapy in metastatic hormone-sensitive prostate cancer: updated network meta-analysis stratified by disease volume [published online ahead of print, 2023 Apr 11].Eur Urol Focus. 2023;S2405-4569(23)00094-9. doi:10.1016/j.euf.2023.03.024Ramaswamy A, Proudfoot JA, Ross AE, Davicioni E, Schaeffer EM, Hu JC. Prostate cancer tumor volume and genomic risk.Eur Urol Open Sci. 2023;48:90-97.Thysell E, Khn L, Semenas J, et al. Clinical and biological relevance of the transcriptomic-based prostate cancer metastasis subtypes MetA-C.Mol Oncol. 2022;16(4):846-859. doi:10.1002/1878-0261.13158Sutera P, Deek MP, Van der Eecken K, et al. Genomic biomarkers to guide precision radiotherapy in prostate cancer.Prostate. 2022;82 Suppl 1(Suppl 1):S73-S85. doi:10.1002/pros.24373
Proposed LCD - MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules (DL39650)
CMS National Coverage PolicyTitle XVIII of the Social Security Act, 1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary.42 CFR 410.32(a) Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: ConditionsCMS Internet-Only Manual, Pub. 100-02, Medicare Policy Manual, Chapter 15, 80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests, 80.1.1 Certification ChangesCoverage Indications, Limitations, and/or Medical NecessityThis contractor will cover molecular diagnostic tests for use in a beneficiary with an indeterminate or suspicious thyroid nodule when all the following criteria are met:The patient:Has not been tested with the same or similar assay for the same clinical indication AND:Has an indeterminate thyroid nodule as defined by Bethesda categories III-IV ORHas a Bethesda category V nodule for which molecular testing may aid in further stratifying the type of malignancy.The results of the test will be used to aid in surgical decision making after a consideration of clinical, radiographic and cytologic features.The beneficiary is within the population and has the indication for which the test was developed. The laboratory providing the test is responsible for clearly indicating to treating clinicians the population and indication for test use.The test demonstrates analytical validity, including both analytical and clinical validation, on a cohort of patients appropriate for its intended use. If the test relies on an algorithm, the algorithm must be validated in a cohort that is not a development cohort for the algorithm.The test has demonstrated clinical validity and utility in peer-reviewed, published literature, establishing a clear and significant biological/molecular basis for stratifying patients and subsequently selecting (either positively or negatively) a clinical management decision in a clearly defined population.The test successfully completes a technical assessment that ensures the test is reasonable and necessary as described above.The performance characteristics of the test have been demonstrated to be as good or better than currently covered services.NOTE: Next Generation Sequencing (NGS) performed to identify genetic variants in samples classified as malignant is not within the scope of this policy but may fall under other established policies.General InformationAssociated InformationN/ASources of InformationN/ABibliography
Proposed LCD - MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules (DL39650)
National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER) Cancer Stat Facts: Thyroid Cancer. Accessed 6/26/2023.https://seer.cancer.gov/statfacts/html/thyro.htmlChen DW, Yeh MW. Disparities in thyroid care.Endocrinol Metab Clin North Am. 2022;51(2):229-241. doi:10.1016/j.ecl.2021.11.017Henley SJ, Ward EM, Scott S, et al. Annual report to the nation on the status of cancer, part I: national cancer statistics.Cancer.2020;126(10):2225-2249. doi:10.1002/cncr.32802Lorusso L, Cappagli V, Valerio L, et al. Thyroid cancers: from surgery to current and future systemic therapies through their molecular identities.Int J Mol Sci. 2021;22(6):3117. doi:10.3390/ijms22063117Chernock RD, Hagemann IS. Molecular pathology of hereditary and sporadic medullary thyroid carcinomas.Am J Clin Pathol. 2015;143(6):768-777. doi:10.1309/AJCPHWACTTUYJ7DDMolinaro E, Romei C, Biagini A, et al. Anaplastic thyroid carcinoma: from clinicopathology to genetics and advanced therapies.Nat Rev Endocrinol. 2017;13(11):644-660. doi:10.1038/nrendo.2017.76Davies L, Welch HG. Current thyroid cancer trends in the United States.JAMA Otolaryngol Head Neck Surg. 2014;140(4):317-322. doi:10.1001/jamaoto.2014.1Hoang JK, Nguyen XV, Davies L. Overdiagnosis of thyroid cancer: answers to five key questions.Acad Radiol. 2015;22(8):1024-1029. doi:10.1016/j.acra.2015.01.019
Proposed LCD - MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules (DL39650)
Kitahara CM, Sosa JA. Understanding the ever-changing incidence of thyroid cancer.Nat Rev Endocrinol. 2020;16(11):617-618. doi:10.1038/s41574-020-00414-9Lim H, Devesa SS, Sosa JA, Check D, Kitahara CM. Trends in thyroid cancer incidence and mortality in the United States, 1974-2013.JAMA. 2017;317(13):1338-1348. doi:10.1001/jama.2017.2719Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid cancer epidemic? The increasing impact of overdiagnosis.N Engl J Med. 2016;375(7):614-617. doi:10.1056/NEJMp1604412Lee M, Powers AE, Morris LGT, Marti JL. Reversal in thyroid cancer incidence trends in the United States, 2000-2017.Thyroid. 2020;30(8):1226-1227. doi:10.1089/thy.2020.0321Megwalu UC, Moon PK. Thyroid cancer incidence and mortality trends in the United States: 2000-2018.Thyroid. 2022;32(5):560-570. doi:10.1089/thy.2021.0662Nikiforov YE, Seethala RR, Tallini G, et al. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: a paradigm shift to reduce overtreatment of indolent tumors.JAMA Oncol. 2016;2(8):1023-1029. doi:10.1001/jamaoncol.2016.0386Haugen BR, Sawka AM, Alexander EK, et al. American Thyroid Association guidelines on the management of thyroid nodules and differentiated Thyroid Cancer Task Force review and recommendation on the proposed renaming of encapsulated follicular variant papillary thyroid carcinoma without invasion to noninvasive follicular thyroid neoplasm with papillary-like nuclear features.Thyroid. 2017;27(4):481-483. doi:10.1089/thy.2016.0628
Proposed LCD - MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules (DL39650)
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid ancer.Thyroid. 2016;26(1):1-133. doi:10.1089/thy.2015.0020Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS committee.J Am Coll Radiol. 2017;14(5):587-595. doi:10.1016/j.jacr.2017.01.046Kitahara CM, Pfeiffer RM, Sosa JA, Shiels MS. Impact of overweight and obesity on US papillary thyroid cancer incidence trends (1995-2015).J Natl Cancer Inst. 2020;112(8):810-817. doi:10.1093/jnci/djz202Ginzberg SP, Soegaard Ballester JM, Wirtalla CJ, et al. Insurance-based disparities in guideline-concordant thyroid cancer care in the era of de-escalation.J Surg Res. 2023;289:211-219. doi:10.1016/j.jss.2023.03.046Radhakrishnan A, Reyes-Gastelum D, Abrahamse P, et al. Physician specialties involved in thyroid cancer diagnosis and treatment: implications for improving health care disparities.J Clin Endocrinol Metab. 2022;107(3):e1096-e1105. doi:10.1210/clinem/dgab781Ginzberg SP, Soegaard Ballester JM, Wirtalla CJ, et al. Racial and ethnic disparities in appropriate thyroid cancer treatment, before and after the release of the 2015 American Thyroid Association Guidelines.Ann Surg Oncol. 2023;30(5):2928-2937. doi:10.1245/s10434-023-13158-3