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 Cancer
- PMID: 26462967
- PMCID: PMC4739132
- DOI: 10.1089/thy.2015.0020
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 Cancer
Abstract
Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members.
Results: The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression therapy using levothyroxine. Recommendations related to long-term management of differentiated thyroid cancer include those related to surveillance for recurrent disease using imaging and serum thyroglobulin, thyroid hormone therapy, management of recurrent and metastatic disease, consideration for clinical trials and targeted therapy, as well as directions for future research.
Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer. They represent, in our opinion, contemporary optimal care for patients with these disorders.
Figures
![<b>FIG. 1.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-1.gif)
![<b>FIG. 2.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-2.gif)
![<b>FIG. 3.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-3.gif)
![<b>FIG. 4.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-4.gif)
![<b>FIG. 5.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-5.gif)
![<b>FIG. 6.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-6.gif)
![<b>FIG. 7.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-7.gif)
![<b>FIG. 8.</b>](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/4739132/bin/fig-8.gif)
Comment in
-
A "new/old method" for TSH stimulation: could a third way to prepare DTC patients for (131)I remnant ablation possibly exist?Eur J Nucl Med Mol Imaging. 2016 Feb;43(2):221-223. doi: 10.1007/s00259-015-3245-9. Epub 2015 Nov 17. Eur J Nucl Med Mol Imaging. 2016. PMID: 26572763 No abstract available.
-
2015 American Thyroid Association Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer and Their Implementation in Various Care Settings.Thyroid. 2016 Feb;26(2):319-21. doi: 10.1089/thy.2015.0530. Epub 2015 Dec 17. Thyroid. 2016. PMID: 26576627 No abstract available.
-
Risk of malignancy in 1502 solid thyroid nodules >1 cm using the new ultrasonographic classification of the American Thyroid Association.Endocrine. 2017 May;56(2):442-445. doi: 10.1007/s12020-016-1163-7. Epub 2016 Nov 12. Endocrine. 2017. PMID: 27837438 No abstract available.
-
The "broken chair" in patients with differentiated thyroid cancer.Endocrine. 2017 Aug;57(2):359-360. doi: 10.1007/s12020-017-1345-y. Epub 2017 Jun 14. Endocrine. 2017. PMID: 28616850 No abstract available.
Similar articles
-
2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer.Thyroid. 2021 Mar;31(3):337-386. doi: 10.1089/thy.2020.0944. Thyroid. 2021. PMID: 33728999 Free PMC article.
-
Implementing Key Changes in the American Thyroid Association 2015 Thyroid Nodules/Differentiated Thyroid Cancer Guidelines Across Practice Types.Endocr Pract. 2018 Sep;24(9):833-840. doi: 10.4158/EP-2018-0130. Endocr Pract. 2018. PMID: 30308136 Review.
-
2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457. Thyroid. 2017. PMID: 28056690
-
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer.Thyroid. 2015 Jul;25(7):716-59. doi: 10.1089/thy.2014.0460. Thyroid. 2015. PMID: 25900731 Free PMC article. Review.
-
Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.Thyroid. 2009 Nov;19(11):1167-214. doi: 10.1089/thy.2009.0110. Thyroid. 2009. PMID: 19860577
Cited by
-
Intraoperative neuromonitoring during thyroidectomy does not decrease vocal cord palsy risk, but the cumulative experience of the surgeon may.Surg Today. 2024 Jun 6. doi: 10.1007/s00595-024-02871-5. Online ahead of print. Surg Today. 2024. PMID: 38842555
-
Prediction of Follicular Thyroid Neoplasm and Malignancy of Follicular Thyroid Neoplasm Using Multiparametric MRI.J Imaging Inform Med. 2024 Jun 5. doi: 10.1007/s10278-024-01102-0. Online ahead of print. J Imaging Inform Med. 2024. PMID: 38839672
-
Washout CYFRA 21-1: A tool to improve diagnostic accuracy of fine needle aspiration in the diagnosis of metastatic lymph nodes in papillary thyroid cancer.Heliyon. 2024 May 21;10(11):e31682. doi: 10.1016/j.heliyon.2024.e31682. eCollection 2024 Jun 15. Heliyon. 2024. PMID: 38828358 Free PMC article.
-
Psychological impacts of lobectomy and total thyroidectomy in PTC measuring 1 to 4 cm with low to intermediate risk of recurrence.Endocrine. 2024 Jun 1. doi: 10.1007/s12020-024-03893-2. Online ahead of print. Endocrine. 2024. PMID: 38822895
-
Mapping the lymph node metastasis landscape: A bibliometric Odyssey of papillary thyroid carcinoma publications (2012-2022).Heliyon. 2024 May 16;10(10):e31398. doi: 10.1016/j.heliyon.2024.e31398. eCollection 2024 May 30. Heliyon. 2024. PMID: 38818149 Free PMC article.
References
-
- Vander JB, Gaston EA, Dawber TR. 1968. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 69:537–540 - PubMed
-
- Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. 1977. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 7:481–493 - PubMed
-
- Tan GH, Gharib H. 1997. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 126:226–231 - PubMed
-
- Guth S, Theune U, Aberle J, Galach A, Bamberger CM. 2009. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 39:699–706 - PubMed
-
- Hegedus L. 2004. Clinical practice. The thyroid nodule. N Engl J Med 351:1764–1771 - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials