Controversies in the surveillance of patients with well differentiated thyroid cancer

Thyroid cancer incidence is rising in the USA, likely due to increased surveillance. Over the past several years, new approaches have developed for the long-term monitoring of differentiated thyroid cancer patients. The most recent developments in this area, as well as interesting data on molecular genetics of thyroid cancer will be discussed.

The introduction of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging in the follow-up of patients with differentiated thyroid cancer is an important development in the last few years. Recent research has helped improve understanding of how 18F-FDG PET can best be applied. There is now improved understanding of the use of serum thyroglobulin levels to predict future risk of recurrence of differentiated thyroid cancer. Guidelines from the American Thyroid Association for management of thyroid neoplasia were updated in 2006 for the first time in a decade, helping physicians navigate the published data and provide evidence-based care. Ongoing advances in thyroid cancer genetics may help predict aggressiveness of individual thyroid cancers.

Better tools are becoming available for physicians caring for thyroid cancer patients. Recent developments in thyroid cancer research will help physicians better anticipate a patient's future disease course and select appropriate surveillance testing.