Factors associated with physicians’ recommendations for managing low-risk papillary thyroid cancer Journal Article


Authors: McDow, A. D.; Roman, B. R.; Saucke, M. C.; Jensen, C. B.; Zaborek, N.; Jennings, J. L.; Davies, L.; Brito, J. P.; Pitt, S. C.
Article Title: Factors associated with physicians’ recommendations for managing low-risk papillary thyroid cancer
Abstract: Background: The 2015 American Thyroid Association endorsed less aggressive management for low-risk papillary thyroid cancer (LR-PTC). We aimed to identify factors influencing physicians’ recommendations for LR-PTC. Methods: We surveyed members of three professional societies and assessed respondents’ recommendations for managing LR-PTC using patient scenarios. Multivariable logistic regression models identified clinical and non-clinical factors associated with recommending total thyroidectomy (TT) and active surveillance (AS). Results: The 345 respondents included 246 surgeons and 99 endocrinologists. Physicians’ preference for their own management if diagnosed with LR-PTC had the strongest association with their recommendation for TT and AS (TT: OR 12.3; AS: OR 7.5, p < 0.001). Physician specialty and stated patient preference were also significantly associated with their recommendations for both management options. Respondents who received information about AS had increased odds of recommending AS. Conclusions: Physicians’ recommendations for LR-PTC are strongly influenced by non-clinical factors, such as personal treatment preference and specialty. © 2021 Elsevier Inc.
Keywords: active surveillance; thyroidectomy; thyroid cancer; survey; low-risk; overtreatment
Journal Title: American Journal of Surgery
Volume: 222
Issue: 1
ISSN: 0002-9610
Publisher: Elsevier Inc.  
Date Published: 2021-07-01
Start Page: 111
End Page: 118
Language: English
DOI: 10.1016/j.amjsurg.2020.11.021
PUBMED: 33248684
PROVIDER: scopus
PMCID: PMC8262457
DOI/URL:
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
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  1. Benjamin Raphael Roman
    75 Roman