September 2026 · Executive Brief
Thyroid Cancer Awareness Month 2026: Turn Awareness into an Accountable Care Route
Use September to test whether a thyroid finding becomes an accepted handoff, a risk-informed decision, an accessible plan, and durable follow-through with no person left between services.
Leadership signal
Awareness creates a duty to make the route visible.
American Association for Cancer Research: Thyroid Cancer Awareness Month identifies September as the observance period. For healthcare executives, the month can be more than a communication cycle. It can become a controlled test of the operating route that begins with a symptom, incidental image, physical finding, family concern, or follow-up need and continues across primary care, imaging, pathology, endocrinology, surgery, oncology, nuclear medicine, navigation, and survivorship.
The central management problem is not that every thyroid finding requires the same action. It is that the route can become unclear precisely when risk, uncertainty, preference, and capacity require a careful response. A result may be visible in the electronic record while no team has accepted the next step. An imaging report may recommend follow-up without a named receiver. A specimen may be sent for molecular testing without a documented plan for how the result will alter a decision. A referral may be transmitted to a high-volume center while travel, coverage, language, or caregiving burden remains unresolved. An active-surveillance plan may be clinically reasonable but operationally fragile if scheduling, ultrasound comparability, or escalation ownership is inconsistent.
Current research shows why leaders should resist a single-message campaign. In a 2026 survey across five specialties, physician familiarity with active-surveillance guidance was high, yet adoption remained low. Specialty and professional rank were associated with recommendations, and responses to patient anxiety varied.1 The study is small and regional, but it exposes a familiar implementation gap: knowing that an option exists does not ensure that teams describe it consistently, apply eligibility criteria reliably, or support the follow-up work it requires.
Patient preferences can diverge from assumptions made by professionals. In a 2025 discrete-choice experiment with 143 adults at three sites, participants weighed recurrence risk, voice change, thyroid-hormone supplementation, hypocalcemia, and possible future surgery. When options were unlabeled, 49% chose the profile representing active surveillance, 29% chose total thyroidectomy, and 22% chose hemithyroidectomy. Perceived recurrence risk exerted the strongest influence.7 The experiment used a hypothetical scenario and does not establish comparative clinical effectiveness. It does show that an understandable description of trade-offs is operationally essential.
Access and expertise create another leadership tension. Rural surgeons interviewed in a qualitative study described limited access to endocrinology, professional isolation, and gaps in continuing education. They also identified university connections, expert consultation, and telemedicine as useful supports.10 These are unranked professional perspectives from a small sample, not prevalence estimates. They nevertheless point to a governance question: can the organization extend expertise without shifting every burden onto the patient?
Centralization can improve access to specialized experience while increasing fragmentation. A National Cancer Database study of 131,620 people with differentiated thyroid cancer found that 53.3% met the study definition of fragmented care. Fragmentation was associated with treatment at the highest-volume institutions and longer travel. It also showed minor treatment delays and better overall survival for stages 1 through 3, a pattern likely influenced by selection and referral factors.16 Leaders should not translate that association into a simple centralized-versus-local choice. The management task is to combine appropriate expertise with reliable transfer of information, accepted ownership, and workable support.
The observance therefore offers a precise executive commitment. Select one real route, define every transition, test it with people who use and operate it, and keep exceptions visible until an authorized owner resolves or escalates them. Measure the progression from finding to accepted responsibility, not just the number of messages published or referrals sent.
Evidence to action
Preserve the difference between clinical evidence and operating evidence.
Executives need a portfolio rather than a headline. A prospective cohort can describe how a defined active-surveillance program performed under specified selection and follow-up conditions. A diagnostic-performance study can show how a test behaved in one case mix. A registry can identify patterns but cannot fully explain why they occurred. A qualitative study can reveal barriers without ranking them. A discrete-choice experiment can expose preferences without determining the best clinical option. Combining these designs into one effect estimate would create false precision.
Preference signal
A three-site discrete-choice experiment found that recurrence risk strongly shaped choices among active surveillance, hemithyroidectomy, and total thyroidectomy profiles.7 Use this as a communication-design signal, not a treatment recommendation.
Reliability signal
In a Canadian prospective cohort, active surveillance was durable for many people, but crossover differed by age and occurred for progression, preference, and imaging limitations.8 A surveillance route needs clinical and operational capacity.
Equity signal
Diagnostic and outcome studies identified differences by race, insurance, geography, and community conditions.2,11,12 Differences require investigation, not biological assumptions.
One verified cohort provides a methodologically appropriate evidence chart. Sawka and colleagues followed 200 adults with small, localized, low-risk papillary thyroid cancer at a Canadian tertiary center. One hundred fifty-five chose active surveillance and 45 chose immediate surgery. Median follow-up was 71 months. The overall crossover from active surveillance was 23.9%, and crossover reasons included disease progression, patient preference, and an imaging limitation. Five-year cumulative crossover incidence was 41.5% for people younger than 45, 20.9% for ages 45 through 64, and 5.1% for ages 65 and older. Each estimate included a 95% confidence interval.8
Figure 1. Five-year crossover from active surveillance by age group
A 2025 systematic review and meta-analysis adds breadth while reinforcing caution. It included 14 comparative and 7 noncomparative studies, with 9,397 patients. The pooled disease-progression rate during active surveillance was 14.53%, with a 95% confidence interval from 9.59% to 21.43%, and delayed surgery occurred in 14.91%, with a 95% confidence interval from 8.35% to 25.21%. No thyroid-cancer-related mortality was observed in the included active-surveillance or immediate-surgery groups. Heterogeneity, nonrandom treatment selection, and differences in follow-up limit direct comparisons.9 The executive conclusion is not that surveillance is universally preferable. It is that any organization offering it needs explicit selection, imaging, communication, scheduling, crossover, and escalation infrastructure.
Post-treatment follow-up also benefits from disciplined interpretation. Miao and colleagues compared 18 patients who received additional radioactive iodine with 118 managed through follow-up after an indeterminate response to initial treatment. The follow-up group had a higher excellent-response rate, and selected factors were associated with persistent non-excellent response.3 The groups were not randomized, and the retreatment group was small. Leaders should use the study to support risk-stratified review and complete follow-up, not to dictate individual treatment.
The evidence boundary matters in public communication. Awareness content should not imply that every person needs screening, that every nodule is cancer, that one molecular result determines treatment, or that all thyroid cancers share the same risk. Messages should direct people to qualified evaluation while the organization ensures that demand connects to a real route with capacity and ownership.
Closed-loop reliability
A result becomes care only when responsibility is accepted.
The route begins before a specialist visit. Entry signals may include a physical finding, symptom, imaging result, cytology report, family concern, prior treatment record, or overdue surveillance task. The first operational requirement is to capture the signal in a work queue that has an accountable receiver, defined urgency categories, and a method for identifying missing information. An inbox, referral order, or report distribution list is not proof that a person accepted responsibility.
Diagnostic transitions require structured information. Inman and colleagues reviewed ultrasound reports for 211 adults who later underwent thyroid surgery. Reports contained a mean 5.1 of 11 recommended elements, and more complete reports were associated with shorter intervals from ultrasound to biopsy and surgery.18 The study is older, retrospective, and restricted to a surgical cohort. Its executive value is the relationship between information completeness and flow. A receiving team should know whether the minimum data required for triage are present, who will obtain missing elements, and how the sender will see the accepted next step.
The route should branch when evidence and preference branch. A person may require additional imaging, repeat sampling, molecular testing, surgery, multidisciplinary review, active surveillance, oncology treatment, radioactive-iodine planning, or another locally authorized pathway. The branch must be recorded as a decision with the evidence considered, the person's goals and questions, the owner, the next action, the due date, and the escalation trigger. A generic note such as "follow up" is not an operating plan.
Figure 2. Proposed closed-loop thyroid-cancer care route
Define the acceptance standard
A reliable handoff states the question, includes the minimum information, identifies the receiving service, records acceptance, and returns a visible status to the sender and the person. If the receiving team declines or redirects the request, the work remains open until another authorized owner accepts it. If capacity delays the next step, the route names who monitors the delay, what condition triggers escalation, and how the person can report a change. The system should never convert a full schedule into invisible risk.
Separate clinical urgency from operational aging
Clinical urgency belongs to authorized clinicians and current policy. Operational aging is a management signal. It asks how long work has remained without acceptance, a completed next action, or an approved exception. Leaders can review aged work without inventing a clinical deadline. The review should display entry date, current owner, last meaningful action, next due action, barrier category, and escalation status.
Design recovery into every branch
People miss visits, images arrive in incompatible formats, test results remain pending, referrals are declined, coverage changes, and preferences evolve. Recovery should be a normal part of the route. Define who notices the break, which channels are appropriate, when the sending team is notified, how urgent change is handled, and when the exception reaches executive review. A closed loop is not a promise that every plan proceeds unchanged. It is a commitment that a changed or interrupted plan does not become unowned.
Diagnostic stewardship
Molecular testing needs governance around the result.
Molecular testing can refine risk in selected indeterminate thyroid nodules, but its value depends on pretest probability, case mix, platform performance, specimen quality, and the decision that follows. The organization should know who orders the test, which specimens are eligible, how adequacy is confirmed, how the result enters the record, who explains uncertainty, and how discordance is handled. A positive or negative category should never float outside the clinical context that gives it meaning.
Swaminathan and colleagues studied 231 patients with nodules at least 4 cm. Among indeterminate nodules tested with Afirma, negative predictive value was 85.7% for the Gene Expression Classifier and 89.5% for the Genomic Sequencing Classifier. False negatives included anaplastic carcinoma, oncocytic carcinoma, and noninvasive follicular thyroid neoplasm with papillary-like nuclear features.4 The study was retrospective and single center. Its practical implication is not a universal threshold. It is a requirement to state what population a predictive value represents and how residual risk will be managed.
Connelly and colleagues evaluated 1,252 cytologically indeterminate nodules across three molecular platforms. Only 209 underwent resection, creating a verification limitation. The platforms had lower negative predictive values in this cohort than some previously published estimates.13 Leaders should therefore resist vendor-level shorthand such as "rules out cancer" unless the exact evidence, population, and uncertainty support the statement. Laboratory, pathology, endocrine, surgery, and data leaders should agree on report language, decision support, and quality review.
Equity review belongs in diagnostic stewardship. Song and colleagues analyzed 662 indeterminate nodules and reported nonsignificant trends toward lower sensitivity and negative predictive value among Black patients. The number of surgically verified cases was limited, and the differences were not statistically definitive.12 The study should not be used to assign biological meaning to race or to create a race-based correction. It should prompt local evaluation of case mix, specimen quality, access to follow-up, verification patterns, and whether test performance is being monitored across groups without reinforcing inequity.
Diagnostic stewardship also includes cost and burden, even when a study focuses on performance. Repeat procedures, travel, delayed surgery, avoidable surgery, uncertain observation, and unaffordable testing all matter. Before expanding a test, executives should require a defined eligible population, expected decision impact, laboratory turnaround standard, coverage process, specimen-recovery pathway, and post-result audit. Review whether the test changed a decision, whether the decision matched the final information available, and whether any group experienced a different route.
Access and equity
Investigate where the route places burden on the person.
Access is not one variable. It includes geography, transportation, coverage, time away from work, caregiving, language, disability access, digital access, trust, appointment availability, referral rules, and the cost of moving between systems. An organization may offer technically available care while requiring a person to coordinate records, identify specialists, negotiate coverage, arrange travel, and interpret conflicting recommendations. That is not a neutral design.
The rural qualitative study identified limited endocrinology access, professional isolation, and continuing-education gaps, while highlighting expert networks and telemedicine as potential supports.10 A strong hub-and-spoke design should support local teams without assuming every case can remain local or that telehealth solves every barrier. It needs referral criteria, consultation turnaround, shared documentation, image and pathology transfer, escalation, and a plan for people who cannot use digital services.
Registry evidence adds another view. Monreal and colleagues found that stage, insurance, age, treatment, and mortality associations differed across racial and ethnic groups among people with aggressive papillary-thyroid-cancer variants. Nonprivate insurance was an important risk factor in several groups, and Black patients presented with larger tumors and had lower thyroidectomy rates.11 The database cannot establish the mechanism. Leaders should treat these patterns as a signal to examine entry, referral, time, acceptance, treatment availability, and follow-up with local data and direct listening.
Ghazy and colleagues examined 17,538 U.S. pediatric and adolescent cases and found differences in incidence by age, sex, race or ethnicity, geography, and period. A marked decline in 2020 was consistent with diagnostic disruption.2 Incidence is influenced by detection and diagnostic intensity and is not a direct measure of care quality. Still, the study demonstrates that observed burden can change when access to diagnosis changes. Executives should interpret trends with attention to data completeness and service disruption.
Figure 3. Qualitative fishbone for delay and fragmentation
Stratify the stage, not just the final outcome
A final treatment or survival measure is too late to locate many access failures. Stratify entry-to-triage completion, referral acceptance, time awaiting missing information, completed diagnostic resolution, decision support, chosen-plan start, surveillance completion, survivorship contact, and unresolved exceptions. Use the matching denominator at each stage. A difference in referral rate means little if the eligible population, reason for referral, or destination capacity differs.
Pair numbers with experience
Ask people where they were uncertain, what work they had to perform, which costs or logistics mattered, whether choices were understandable, and whether they knew whom to contact. Include people who declined, transferred, missed, or discontinued a route. These experiences can reveal conditions that a completed-visit dataset cannot see. Protect privacy, compensate participation where appropriate, and avoid using one person's story as a prevalence estimate.
Governance
Run the pathway as a cross-functional operating system.
No single team controls the full route. Primary care may own continuity and context. Radiology produces risk-relevant imaging information. Cytology and pathology establish specimen quality and diagnostic findings. Endocrinology and surgery may share risk assessment and treatment decisions. Oncology and nuclear medicine may manage additional therapy for selected people. Navigation may address access and cross-system movement. Data and quality teams can expose aged work and variation. Executive governance must clarify who has authority when those functions conflict or when capacity fails.
Volume evidence supports deliberate referral without reducing quality to a number. In an Ontario cohort of 1,832 patients undergoing thyroidectomy and lateral neck dissection, the lowest surgeon-volume tertile remained an independent predictor of poorer disease-free survival after adjustment, with a hazard ratio of 1.71 and a 95% confidence interval from 1.22 to 2.40.15 The threshold was context-specific and observational. A statewide U.S. study of 3,199 patients similarly found higher readmission, reoperation, complication, and emergency-visit rates among low-volume surgeons across the study period.14 Leaders should use local credentialing, outcomes, capability, complexity, and access data, not copy a universal cutoff.
Referral to expertise must include continuity. The fragmentation study found that cross-facility care was common and connected to high-volume centers and travel.16 A referral contract should define which team owns previsit work, record transfer, pending tests, postprocedure communication, medication or hormone management, urgent questions, surveillance, and return to local care. The person should not be the integration layer.
Figure 4. Proposed thyroid-cancer operating system
Executive sponsor
Sets the measurable aim, protects capacity, resolves cross-functional conflicts, and reviews aged exceptions and unintended burden.
Clinical governance
Controls eligibility, risk assessment, diagnostic interpretation, treatment, surveillance, urgent escalation, and clinical documentation under current guidance.
Operational route owner
Maintains the handoff standard, service directory, minimum information, work queues, escalation map, training triggers, and implementation calendar.
Person and chosen support
Shape communication, decision support, burden assessment, experience measures, and improvement priorities. Participation must be respectful and voluntary.
Data and quality
Validate stage-specific denominators, monitor exceptions, protect privacy, distinguish missing data from poor performance, and prevent misleading comparisons.
Access and navigation
Resolve coverage, travel, language, disability, scheduling, technology, record-transfer, and specialist-access barriers while preserving nondigital options.
Survivorship
Long survival does not eliminate the need for durable ownership.
Survivorship can include monitoring, medication management, fatigue, sleep concerns, anxiety, depression, fear of recurrence, fertility or reproductive questions, work disruption, financial burden, and uncertainty about which team to contact. These needs may move between endocrinology, oncology, surgery, primary care, behavioral health, rehabilitation, and community support. Without a written ownership model, responsibility can diffuse after the most visible treatment ends.
Hamurcu and colleagues studied 518 biochemically stable differentiated-thyroid-cancer survivors in Türkiye. Anxiety and depression were strongly associated with lower health-related quality of life and greater fatigue.5 The study was cross-sectional and cannot establish cause. It supports a practical question: does the follow-up route detect psychosocial need and connect it to appropriate support, or does it focus only on disease markers?
A propensity-matched retrospective cohort of 10,882 women ages 18 through 49 found that radioactive-iodine treatment was associated with higher one-year rates of fatigue and malaise, depressive episodes, sleep disorders, and primary-care visits.6 Coded EHR data and residual confounding limit causal interpretation. The operating implication is to anticipate cross-service utilization, clarify which symptoms require urgent or routine review, and give primary care a complete treatment and follow-up summary.
Worry can persist long after diagnosis. A two-wave survey of 273 Hispanic women found that 20.1% to 39.6% had high worry in both waves across five domains, while another 7.6% to 13.4% shifted from low to high worry. Younger age was associated with recurrence worry, and persistent or recurrent disease was associated with worry about treatment harm.17 The regional self-reported sample does not estimate experience for every survivor. It does show why clear communication, symptom review, and psychosocial referral should not disappear when prognosis is favorable.
A survivorship handoff should identify the current risk and monitoring plan, responsible clinicians, treatment history, medication responsibilities, symptom and psychosocial review, late-effect considerations, reproductive or fertility needs where relevant, urgent-contact instructions, and the next scheduled action. It should also state who coordinates if a result or symptom changes the route. The person should receive an understandable version and know how to correct inaccurate information.
Measurement
Measure each stage with its own denominator.
A route scorecard should not collapse unlike stages. The denominator for accepted referral is referrals sent. The denominator for diagnostic resolution is people for whom evaluation was due under the locally defined route. The denominator for a shared plan is people reaching a decision point. The denominator for surveillance completion is people with surveillance due. The denominator for experience is people given a valid opportunity to respond. A single completion percentage cannot locate where the route narrows.
Targets should follow a validated baseline, capacity review, clinical governance, and equity analysis. External study values are not local benchmarks. Use run charts or control charts only after definitions and data quality are stable. Pair quantitative signals with case review and direct experience, especially when variation appears across geography, race or ethnicity, insurance, language, age, disability, or care setting.
Figure 5. Structured thyroid-cancer route scorecard
| Measure | Numerator | Denominator | Source and owner | Cadence | Interpretation limit |
|---|---|---|---|---|---|
| Signal captured | Eligible findings entered into the approved work queue | Findings meeting the validated local definition | EHR and imaging audit; route owner | Weekly | Capture does not prove acceptance |
| Complete referral | Referrals containing the approved minimum information | Referrals sent | Referral platform; sending and receiving leads | Weekly | Completeness standard must match local policy |
| Accepted ownership | Referrals with a named receiving owner and status | Referrals sent | Referral log; receiving service | Weekly | Acceptance does not prove completed evaluation |
| Diagnostic resolution | People reaching the defined diagnostic disposition | People with evaluation due | Imaging, pathology, and EHR; clinical governance | Monthly | Disposition categories must be clinically governed |
| Molecular-result closure | Results with interpretation, communication, and next action documented | Valid molecular results returned | Laboratory and EHR; diagnostic owner | Monthly | Documentation does not prove understanding |
| Shared plan | Decision points with options, preference, owner, and next step documented | People reaching a decision point | EHR and audit; clinical lead | Monthly | Decision quality needs experience evidence |
| Chosen plan started | Plans with verified first action | People who selected a plan | Procedure, referral, or surveillance record; route owner | Weekly and monthly | An order is not a completed start |
| Surveillance completed | Due monitoring completed within the approved window | People with monitoring due | Imaging and EHR; surveillance owner | Monthly | Timing depends on patient-specific clinical plans |
| Survivorship handoff | Eligible people with owner, summary, next action, and escalation route documented | People entering survivorship or long-term follow-up | Care plan audit; survivorship lead | Monthly | Document presence does not prove usability |
| Aged exceptions | Open exceptions beyond the locally approved operational due time | All logged exceptions | Exception log; executive sponsor | Weekly | Depends on complete and consistent logging |
| Experience and burden | Respondents meeting defined understanding, respect, and usability criteria | People offered a valid response opportunity | Experience tool; partnership lead | Quarterly | Response bias and question wording affect results |
| Equity review | The stage-specific numerator selected above | Its matching stage-specific denominator | Validated linked data; quality and equity leads | Quarterly | Differences do not establish cause |
Balancing measures matter. Monitor avoidable repeat testing, cancelled or declined visits, travel burden, out-of-pocket concern, incomplete records, staff workload, alert burden, unplanned utilization, complications, and patient-reported confusion. Improvement that accelerates one stage while shifting work or risk to another is not complete.
Executive agenda
A 90-day test can expose the real route.
Days 1 to 30
Define and verify
- Name the executive sponsor, clinical authority, operational route owner, data lead, and patient-partnership lead.
- Select one entry point and map the current route with people who use and operate it.
- Define minimum information, acceptance, diagnostic resolution, shared decision, start, surveillance, survivorship, and exception states.
- Validate a baseline sample against source records.
- Confirm capacity before promoting a call to action.
Days 31 to 60
Build and rehearse
- Create the minimum viable work queue and acceptance signal.
- Standardize critical imaging, pathology, molecular, and referral information.
- Rehearse declined referrals, missing images, pending pathology, coverage problems, patient anxiety, and surveillance loss.
- Test specialist support and nondigital access options.
- Start a small pilot with daily exception review.
Days 61 to 90
Learn and decide
- Review stage-specific conversion, elapsed time, burden, experience, stratified variation, and balancing measures.
- Investigate differences using local records and direct listening.
- Correct verified conditions and recheck the route.
- Report evidence limits, data quality, capacity, cost, and unresolved risk.
- Adapt, expand, pause, or stop based on governance review.
Figure 6. Proposed 90-day implementation timeline
The executive report at day 90 should distinguish what changed from what remains uncertain. Include the tested population, route boundaries, data quality, stage-specific results, experience, equity review, balancing measures, staff burden, capacity, and open risks. Do not claim that an observance caused an outcome when the design cannot support that conclusion.
Leadership close
Make the route easier to trust.
Thyroid Cancer Awareness Month can generate questions, concern, and requests for care. The strongest response is not a larger volume of messages. It is an operating system in which a finding is captured, information is complete, responsibility is accepted, choices are understandable, the selected route is feasible, and follow-up remains visible.
Executives can start with one path and one promise: no sent referral, pending result, changed plan, or missed follow-up becomes unowned. Pair that promise with qualified clinical governance, capacity, direct listening, stage-specific measurement, and weekly exception review. Then report what improved and what still requires action.
Peer-reviewed evidence portfolio
References
Newest scholarship is listed first. Every record was individually verified as peer reviewed through the authorized academic research workflow.
- Huang Q, Tang C, Sun Z, et al. A cognitive divide in active surveillance acceptance persists between surgeons and endocrinologists managing low-risk thyroid cancer. Scientific Reports. 2026;16(1). doi:10.1038/s41598-026-39919-0.
- Ghazy RM, Sun C, Alshaikh AA, Vinh T. Racial/ethnic disparities and geographic clustering in pediatric thyroid cancer incidence in the United States, 1999-2022, with forecasts to 2027. Cancer Epidemiology. 2026;102:103050. doi:10.1016/j.canep.2026.103050.
- Miao J, Cheng W, Ding L, et al. Comparative outcomes of retreatment vs follow-up in DTC patients with intermediate response following initial radioactive iodine therapy: a retrospective cohort study. BMC Cancer. 2026;26(1). doi:10.1186/s12885-026-15926-2.
- Swaminathan N, Song Z, Wu C, et al. Diagnostic value of molecular testing for evaluating thyroid nodules greater than 4 centimeters. American Journal of Surgery. 2026;252:116755. doi:10.1016/j.amjsurg.2025.116755.
- Hamurcu HD, Kokurcan A, Uçmak G, Çayköylü A. Anxiety, depression, and quality of life among survivors of differentiated thyroid cancer in Türkiye. International Journal of Psychiatry in Medicine. 2026;61(5):558-573. doi:10.1177/00912174251413349.
- Devanarayan P, Hartman M, Partin M. Association of radioactive iodine treatment with survivorship symptoms and primary care utilisation in women of reproductive age with thyroid cancer: a retrospective cohort study. Family Medicine and Community Health. 2026;14(3). doi:10.1136/fmch-2026-004118.
- Hampton J, Cooper G, Wall L, et al. Risk of cancer recurrence exerts the strongest influence on choice between active surveillance and thyroid surgery as initial treatment for low-risk thyroid cancer: results of a discrete choice experiment. World Journal of Surgery. 2025;49(5):1254-1263. doi:10.1002/wjs.12520.
- Sawka AM, Ghai S, Rotstein L, et al. Long-term durability of active surveillance of small, low-risk papillary thyroid cancer. JAMA Surgery. 2025;160(10):1117-1124. doi:10.1001/jamasurg.2025.2957.
- Nguyen VC, Song CM, Ji YB, et al. Outcomes and effectiveness of active surveillance for low-risk papillary thyroid carcinoma: a systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology. 2025;282(5):2239-2252. doi:10.1007/s00405-024-09141-7.
- Huston-Paterson HH, Mao YV, Hughes EG, et al. Closing the distance: a qualitative study to identify equitable innovations for rural thyroid cancer treatment. American Surgeon. 2025;91(4):548-555. doi:10.1177/00031348241307399.
- Monreal AJ, Eze AN, Thomas SM, et al. Exploring actionable targets to address disparities in thyroid cancer survival: a study of patients with aggressive variants of papillary thyroid cancer. American Journal of Surgery. 2025;248:116428. doi:10.1016/j.amjsurg.2025.116428.
- Song Z, Akund R, Wu C, et al. Performance of molecular testing for indeterminate thyroid nodules in Black patients. American Journal of Surgery. 2025;250:116569. doi:10.1016/j.amjsurg.2025.116569.
- Connelly CF, Smithgall MC, Desai N, et al. Performance characteristics of ThyroSeq, ThyGeNEXT/ThyraMIR, and Afirma molecular platforms in evaluation of 1252 cytologically-indeterminate thyroid nodules. Journal of the American Society of Cytopathology. 2025;14(4):243-254. doi:10.1016/j.jasc.2025.04.003.
- Ellsworth BL, Sinco B, Matusko N, et al. Examining national guideline changes association with hemithyroidectomy rates by surgeon volume. Journal of Surgical Research. 2023;283:858-866. doi:10.1016/j.jss.2022.11.037.
- Siu J, Griffiths R, Noel CW, et al. Surgical case volume has an impact on outcomes for patients with lateral neck disease in thyroid cancer. Annals of Surgical Oncology. 2022;29(2):1141-1150. doi:10.1245/s10434-021-10923-0.
- Greenberg JA, Thiesmeyer JW, Egan CE, et al. Care fragmentation in patients with differentiated thyroid cancer. World Journal of Surgery. 2022;46(12):3007-3016. doi:10.1007/s00268-022-06712-9.
- Jackson Levin N, Zhang A, Reyes-Gastelum D, et al. Change in worry over time among Hispanic women with thyroid cancer. Journal of Cancer Survivorship. 2022;16(4):844-852. doi:10.1007/s11764-021-01078-8.
- Inman A, Liu K, Ong K, et al. Completeness of ultrasound reporting impacts time to biopsy for benign and malignant thyroid nodules. American Journal of Surgery. 2017;213(5):931-935. doi:10.1016/j.amjsurg.2017.03.030.
Scope note: This executive brief supports healthcare management, quality improvement, and governance. It does not provide personal medical advice, recommend screening, establish diagnosis, or prescribe an individual treatment. Qualified clinicians should use current guidance, patient-specific information, shared decision-making, and local policy.