ArticleWorld journal of surgery2025
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.
Article in World journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Evolving Practices in Low-Risk Papillary Thyroid Cancer: Impact of the 2015 ATA Guidelines.Current oncology (Toronto, Ont.) · 2026Article
- Development of a Decision Aid for Patients With Low-Risk Thyroid Cancer: A Mixed-Methods Analysis of Feedback From Both Patient and Clinicians.World journal of surgery · 2025Article
- The Fear Factor: How Cancer Recurrence Shapes Treatment Choices About Thyroid Cancer.World journal of surgery · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundTreatment options for low-risk differentiated thyroid cancer (DTC) include active surveillance (AS), hemithyroidectomy (HT), or total thyroidectomy (TT). Improved understanding of patient values and preferences is required to inform shared decision-making. This study examined factors influencing patient treatment preferences and trade-offs for low-risk DTC.
methodsAdult participants with benign thyroid nodules or low-risk DTC completed an online discrete choice experiment (DCE). Utilizing the scenario of a 50-year-old person with a small solitary DTC, participants chose between three unlabeled treatment options (representing AS, HT, and TT). Risk profiles varied across 5 domains: voice change, thyroid hormone supplementation, hypocalcaemia, chance of future thyroid surgery, and 10-year risk of cancer recurrence. Participants self-reported demographics, disease factors, and answered a decisional regret scale. A conditional logit model was utilized.
resultsThe DCE was completed by 143 patients across three sites. The conditional logit model demonstrated that participants preferred AS (49%) over TT (29%) or HT (22%). All five domains influenced choices (all p < 0.001), but perceived risk of cancer recurrence exerted most influence. Cancer survivors chose AS less often than those with benign disease (46% vs. 57%), driven by perceived risks of further surgery and cancer recurrence. As the perceived risk of cancer recurrence increased, more participants preferred HT over AS.
conclusionThis study demonstrates that when blinded to the actual treatment, patients prefer the trade-offs associated with AS rather than TT or HT. Perceived risk of cancer recurrence exerted the greatest influence. Accurate risk stratification for cancer recurrence is critical to shared decision-making.
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