Managing the increasing diagnosis of papillary micro-cancer of thyroid

There has been an increase in the incidence of thyroid cancer in the last decade, mainly due to the increase in imaging. A majority of the cases are for papillary cancers <1 cm. Mortality from thyroid cancer has stayed stable, thus, there is a large pool of papillary micro-cancer of thyroid in the general population without clinical significance. For these cancers a different approach is needed and active surveillance or less aggressive management should be offered as options. Controlled studies of minimally invasive procedures such as ethanol ablation are needed. If surgery is chosen, lobectomy alone should be adequate. Cases of occult papillary micro-cancer with local and distant metastases are very rare and should be managed according to the staging and risk category of the disease.