Thyroid Cancer Active Surveillance Program Retention and Adherence in Japan

Area of Science:

• Endocrinology
• Oncology
• Public Health

Background:

• Papillary thyroid cancer incidence is rising globally.
• Active surveillance offers an alternative to overtreatment for low-risk cases.
• Understanding patient retention and adherence is crucial for broader adoption.

Purpose of the Study:

• To evaluate patient retention, adherence, and experience in a large thyroid cancer active surveillance program.
• To identify factors influencing patient participation in long-term surveillance.

Main Methods:

• A cohort study at Kuma Hospital, Japan, analyzed data from 1179 patients.
• Mixed-methods approach included attendance data, interviews, and observations.
• Adherence defined as ultrasonography within 13 months; retention as surveillance every 2 years.

Main Results:

• High adherence (91%) and retention were observed.
• Only 4.5% switched to surgery, and 8.6% were lost to follow-up.
• Patients valued clear test results, education, and supportive physician interactions.

Conclusions:

• Active surveillance for low-risk papillary thyroid cancer demonstrates good retention and adherence.
• Implementation is feasible, potentially enhanced by a collaborative patient-clinician approach.
• Clinician guidance and support are vital for successful long-term surveillance.