Clinicians not so worried about delays to thyroid cancer treatment


By Mardi Chapman

10 Aug 2021

The COVID-19 pandemic resulted in worldwide delays in thyroidectomies, surveillance imaging, hemi-thyroidectomies, adjuvant and therapeutic radiotherapy, and systemic therapies for thyroid cancer.

According to a study published in the Australian and New Zealand Journal of Surgery, only 10.6% of thyroid cancer surgeons and endocrinologists – mostly local to ANZ – reported not delaying any treatment.

An international survey of 199 clinicians found most (63.8%) were “somewhat or a little bit” and almost a quarter (24.1%) were “very much or quite a bit” worried about the delay in their patients’ treatment.

Interestingly, the most common reported reason for clinician worry was patient anxiety (n = 54; 27.1%).

“Only 27 clinicians (13.6%) reported they were themselves worried about disease progression and seven clinicians (3.5%) reported worry that their patient may need more invasive treatments after treatment delay,” the stuy said.

Clinicians said evidence from peer-reviewed studies, their previous professional experience and current clinical guidelines were the main reasons they felt comfortable with the delays.

“This suggests that while clinicians understand thyroid cancer biology, some still find it difficult to explain this to patients, or feel patients will find it difficult to accept.”

The study also found a high correlation between comfort levels regarding delaying surgery in low-risk thyroid cancer patients in pre-pandemic times and comfort levels delaying treatment due to COVID-19.

“While this survey only provides a snapshot of thyroid clinicians’ views and experiences regarding delayed treatment, specifically surgery, it demonstrates that worry was not excessive and may indicate a growing appreciation of the shift towards active surveillance for those with low-risk thyroid cancer.”

“Although temporarily delaying treatment is different to management through active surveillance, these internationally based findings provide insights into how clinicians offer treatment choices for thyroid cancer.”

The study was led by Dr Brooke Nickel, a NHMRC Emerging Leader Research Fellow in The University of Sydney School of Public Health.

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