The following is a summary of “Current Controversies in Low-Risk Differentiated Thyroid Cancer: Reducing Overtreatment in an Era of Overdiagnosis,” published in the February 2023 issue of Endocrinology & Metabolism by Ullmann, et al.

Although low-risk differentiated thyroid carcinoma (DTC) is often overdiagnozed, the actual incidence has gone up. Because of its great prognosis and low morbidity and mortality, it can be difficult to balance the risks of treatment with the risks of the disease progressing, which has given rise to various areas of debate.

The study provided an overview of the debates and challenging choices surrounding the management of low-risk DTC at every stage, from diagnosis to therapy and follow-up. Overdiagnosis, active surveillance versus surgery, the scope of the operation, radioactive iodine (RAI) treatment, thyrotropin suppression, and postoperative monitoring were studied in particular.

In the last ten years, recommendations for diagnosing DTC, the scope of care for low-risk DTC patients, and the degree of posttreatment follow-up have all altered significantly. Even while overdiagnosis was still an issue, the incidence had gone up. Small tumors can be treated with active surveillance, while larger tumors can be completely removed and then treated with RAI in some circumstances. The frequency and length of the long-term surveillance recommendations were equally broad.

To choose the proper level of treatment individually, clinicians and patients must approach each situation in a tailored and nuanced way. Data on patient-centered outcomes may aid in guiding judgment in situations where there is a lack of conclusive evidence.

Reference: academic.oup.com/jcem/article-abstract/108/2/271/6795262?redirectedFrom=fulltext