- Title
- Current patterns of care in low-risk thyroid cancer—A national cross-sectional survey of Australian thyroid clinicians
- Creator
- Widjaja, Winy; Rowe, Christopher W.; Oldmeadow, Christopher; Cope, Daron; Fradgley, Elizabeth A.; Paul, Christine; O'Neill, Christine J.
- Relation
- Endocrinology, Diabetes & Metabolism Vol. 6, Issue 2, no. e398
- Publisher Link
- http://dx.doi.org/10.1002/edm2.398
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2023
- Description
- Introduction: De-escalated treatment of hemithyroidectomy without radioactive iodine (RAI) is now accepted for patients with low-risk, well-differentiated thyroid cancer (WDTC). The benefit of long-term follow-up care remains controversial. This study aims to describe parameters associated with less than total thyroidectomy, and discharge from specialist follow-up in patients with low-risk WDTC in Australia. Methods: An online survey was distributed to Australian members of Endocrine Society of Australia, Australian and New Zealand Endocrine Surgeons, and Australian Society of Otolaryngology, Head and Neck Surgery. Clinicians completed a survey of management and follow-up care preferences for four clinical vignettes (all low-risk WDTC). Results: 119 clinicians (48% endocrinologists, 55% male) answered at least one question. The majority (59%) of respondents recommended less than total thyroidectomy and omission of RAI in patients with WDTC <2 cm. Most (62%) would discharge a patient with micropapillary thyroid cancer within 1 year following total thyroidectomy. In contrast, for WDTC 1–4 cm, >90% of clinicians would continue specialist follow-up for at least 5 years. The majority of clinicians felt that patients experienced disproportionate fear of recurrence and were reassured by follow-up. After multivariable analysis, clinicians who participated in multidisciplinary teams (MDTs) were more likely to choose de-escalated care for both initial treatment (p = .005) and follow-up care (>5 years, p = .05). Conclusion: Clinician attitudes captured by this survey reflect recent changes in guidelines towards hemithyroidectomy for low-risk WDTC, particularly amongst MDT attendees. There is a need to further examine the impact of de-escalated care on fear of recurrence and quality of life in thyroid cancer survivors.
- Subject
- thyroid cancer; health-related quality of life; thyroidectomy; cancer survivorship; fear of cancer recurrence; multi-disciplinary team; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1479159
- Identifier
- uon:50277
- Identifier
- ISSN:2398-9238
- Language
- eng
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