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Delays to Low-risk Thyroid Cancer Treatment During COVID-19—Refocusing From What Has Been Lost to What May Be Learned and Gained

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Since the World Health Organization declared the novel coronavirus disease 2019 (COVID-19) a global pandemic in March 2020,1 countries around the world have taken unprecedented health measures in response to the outbreak. One of the measures that has been implemented is delaying nonurgent surgical procedures, including those of patients diagnosed with low-risk thyroid cancers. Other treatments, including radioactive iodine, and follow-up appointments have also been delayed along with diagnostic procedures, such as new patient consultations and ultrasound-guided fine-needle aspiration biopsies.

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Article Information

Corresponding Author: Brooke Nickel, MIPH, PhD, Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia (brooke.nickel@sydney.edu.au).

Published Online: October 29, 2020. doi:10.1001/jamaoto.2020.3878

Conflict of Interest Disclosures: Dr Glover reported receiving grant support from the Cancer Institute New South Wales Early Career Fellowship 2019. No other disclosures were reported.

References
1.
WHO Director-General’s opening remarks at the media briefing on COVID-19. News release. March 11, 2020. Accessed March 12, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
2.
Cho  SJ , Suh  CH , Baek  JH ,  et al.  Active surveillance for small papillary thyroid cancer: a systematic review and meta-analysis.   Thyroid. 2019;29(10):1399-1408. doi:10.1089/thy.2019.0159PubMedGoogle Scholar
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Wiltshire  JJ , Drake  TM , Uttley  L , Balasubramanian  SP .  Systematic review of trends in the incidence rates of thyroid cancer.   Thyroid. 2016;26(11):1541-1552. doi:10.1089/thy.2016.0100PubMedGoogle Scholar
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Li  M , Dal Maso  L , Vaccarella  S .  Global trends in thyroid cancer incidence and the impact of overdiagnosis.   Lancet Diabetes Endocrinol. 2020;8(6):468-470. doi:10.1016/S2213-8587(20)30115-7 PubMedGoogle Scholar
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Haugen  BR , Alexander  EK , Bible  KC ,  et al.  2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.   Thyroid. 2016;26(1):1-133. doi:10.1089/thy.2015.0020PubMedGoogle Scholar
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Nickel  B , Brito  JP , Barratt  A , Jordan  S , Moynihan  R , McCaffery  K .  Clinicians’ views on management and terminology for papillary thyroid microcarcinoma: a qualitative study.   Thyroid. 2017;27(5):661-671. doi:10.1089/thy.2016.0483PubMedGoogle Scholar
7.
Nickel  B , Brito  JP , Moynihan  R , Barratt  A , Jordan  S , McCaffery  K .  Patients’ experiences of diagnosis and management of papillary thyroid microcarcinoma: a qualitative study.   BMC Cancer. 2018;18(1):242. doi:10.1186/s12885-018-4152-9 PubMedGoogle Scholar
8.
Jensen  CB , Saucke  MC , Francis  DO , Voils  CI , Pitt  SC .  From overdiagnosis to overtreatment of low-risk thyroid cancer: a thematic analysis of attitudes and beliefs of endocrinologists, surgeons, and patients.   Thyroid. 2020;30(5):696-703. doi:10.1089/thy.2019.0587PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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