Preferences of patients, clinicians, and healthy controls for the management of a Bethesda III thyroid nodule.

Abstract

Active surveillance is propagated as an alternative for hemithyroidectomy in the management of Bethesda III thyroid nodules. A cross-sectional survey questioned respondents on their willingness to accept risks related to active surveillance and hemithyroidectomy. In case of active surveillance, respondents (129 patients, 46 clinicians, and 66 healthy controls) were willing to accept a risk of 10%-15% for thyroid cancer and 15% for needing more extensive surgery in the future. Respondents were willing to accept a risk of 22.5%-30% for hypothyroidism after hemithyroidectomy. Patients and controls were willing to accept a higher risk on permanent voice changes compared with clinicians (10% vs. 3%, p < 0.001). Real-life risks associated which active surveillance and hemithyroidectomy for Bethesda III nodules are equivalent or less than the risks people are willing to accept. Clinicians accepted less risk for permanent voice changes.