Active Surveillance of Thyroid Microcarcinoma-Can This Approach Be Safely Implemented Worldwide?

The incidence of thyroid cancer has been increasing exponentially worldwide, mainly due to increased detection of small papillary thyroid microcarcinomas (PTMCs). Given the indolent nature of the disease, active surveillance (AS) has been suggested as an alternative approach to immediate surgery in the management of low-risk PTMCs. The decision to proceed with AS must take into account patient characteristics, tumor characteristics, and medical team characteristics. In this review, we discuss the rationale and evidence to support AS, as well as important considerations and limitations to implementing this approach for PTMC worldwide.