Table 1.
Analysis of website content about treatment for low-risk thyroid cancer
| Topics considered by stakeholders to be necessary for treatment decision-making | N (%) |
|---|---|
|
| |
| Total thyroidectomy (TT) a treatment option | 22 (100.0) |
| Only appropriate for select ≤ 1-cm cancers* | 1 (4.5) |
| Complications include permanent voice problems | 7 (31.8) |
| Complications include permanent hypocalcemia | 6 (27.3) |
| Describes symptoms of hypocalcemia | 4 (18.2) |
| Follow-up US and labs are needed to monitor for recurrence | 3 (13.6) |
| All patients require lifelong thyroid hormone replacement | 14 (63.6) |
| Lobectomy is a treatment option | 18 (81.8) |
| Recommended treatment for low-risk cancer ≤ 1 cm* | 5 (22.7) |
| Appropriate for low-risk cancer up to 4 cm* | 2 (9.1) |
| Lower recurrent nerve injury rate than TT | 5 (22.7) |
| Lower complication rate than TT | 2 (9.1) |
| Follow-up US and labs are needed to monitor for recurrence | 9 (40.9) |
| Possible to need lifelong thyroid hormone replacement | 8 (36.4) |
| Possible to need a completion thyroidectomy | 1 (4.5) |
| Active surveillance is a management option* | 8 (36.4) |
| Appropriate for cancer ≤ 1 cm or very low risk* | 3 (13.6) |
| Requires serial surveillance US* | 1 (4.5) |
| Avoids the possible complications of surgery | 3 (13.6) |
| Surgery is possible later if the cancer increases in size or spreads | 3 (13.6) |
| Some patients do eventually undergo surgery | 0 (0) |
| No difference in survival at 10 years compared to surgery | 1 (4.5) |
| Thyroid hormone suppression may be needed | 13 (59.1) |
| Follow-up labs are needed to monitor thyroid hormone levels | 9 (40.9) |
| Discusses possible side effects of thyroid hormone replacement | 4 (18.2) |
| Provides instructions for taking thyroid hormone | 3 (13.6) |
| Other | |
| Discusses radioactive iodine as a potential treatment | 21 (95.5) |
| References any guidelines for thyroid cancer treatment | 4 (18.2) |
| States many people have undiagnosed small thyroid cancer without clinical significance | 0 (0) |
*
The 6 italicized statements represent changes in treatment recommendations from the 2009 to the 2015 American Thyroid Association (ATA) guidelines
TT total thyroidectomy, US ultrasound