Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
Volume 19 Issue 9
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Clinical Thyroidology for the Public Volume 19 Issue 9 (PDF file, 2.4 MB)
TABLE OF CONTENTS – Web Format
THYROID CANCER
Active surveillance may work for some larger thyroid cancers too
Cancer size has been one of the main factors used to decide whether active surveillance is appropriate. It was assumed that larger cancers would be more likely to grow or spread, but this assumption has not been studied in detail. In this study, the researchers evaluated the safety and clinical outcomes of active surveillance in patients with papillary thyroid cancers measuring more than 1.5 cm.
Sanchez LP, et al. Active surveillance in papillary thyroid cancer with primary tumors greater than 1.5 cm. Head Neck. Epub 2026 Apr 16; doi: 10.1002/hed.70279. PMID: 41992678
THYROID NODULES
Could my toxic nodule be cancer?
The likelihood that a toxic nodule was also a cancer has been assumed to be extremely low. Indeed, current guidelines suggest that a biopsy to determine if a cancer is present is not needed if a nodule is overactive. The present study aimed to evaluate the ACR TI-RADS classification system in toxic nodules and to determine how often cancer does occur in toxic nodules.
Koelliker E, et al. Sonographic and pathologic features of malignant hot thyroid nodules: a multi-institutional study. Surgery 2026;189:109710
THYROID NODULES
Comparison of ultrasound risk stratification systems for cancer by thyroid nodule size
In the last 10 years, multiple professional societies have developed cancer risk stratification systems for thyroid nodules based on their ultrasound appearance. To simplify this process, the International Thyroid Nodule Ultrasound Working Group recently published a standardized ultrasound vocabulary to be used when assessing the cancer risk of thyroid nodules. The aim of this study was to use the recent standardized ultrasound vocabulary proposed by the international expert consensus to compare the diagnostic performance of the 5 currently used RSSs for thyroid nodules.
Na DG et al et al. Diagnostic performance of five societies’ ultrasound risk stratification systems for thyroid malignancy according to nodule size: a comparison using a standardized ultrasound lexicon. Thyroid 2026;36(4):408–419; doi: 10.1177/10507256261429117. PMID: 41789443
THYROID CANCER
Should I take extra thyroid hormone for my thyroid cancer?
For many years, thyroid cancer patients that were at intermediate or high risk of thyroid cancer recurrence were treated with extra thyroid hormone to get their TSH levels below the normal range. However, recent studies have investigated whether giving extra thyroid hormone to keep the TSH below normal improves thyroid cancer patients’ lifespan. The goal of this study is to examine the effect of extra thyroid hormone on the lifespan of thyroid cancer patients at intermediate and high risk of recurrence, as well as the bad effects of giving extra thyroid hormone replacement.
Gubbi S, et al. The effect of thyrotropin suppression on survival outcomes in patients with differentiated thyroid cancer: a systematic review and meta-analysis. Thyroid 2024;34(6):674–686
THYROID SURGERY
Routine versus selective calcium supplementation after thyroidectomy
Postoperative hypocalcemia (or low calcium levels) following thyroidectomy is a common complication that can be seen transiently in up to 30% of cases. Some providers may choose to routinely start calcium supplementation for all patients following thyroid surgery, while others may selectively recommend calcium supplementation based on postoperative parathyroid hormone levels measured on blood work. This study is a randomized controlled trial comparing the clinical outcomes of routine versus selective calcium supplementation following thyroid surgery.
Garcia-Lozano C et al. Routine vs selective calcium supplementation after total thyroidectomy: a randomized clinical trial. JAMA Otolaryngol Head Neck Surg 2026;152(4):392– 399; doi: 10.1001/jamaoto.2025.5514. PMID: 41712216.
HYPOTHYROIDISM
Thyroid disease and liver function
MASLD is major liver problem that affects ~30% of people worldwide. Studies have shown a strong association between MASLD and hypothyroidism. This study examines the association between hypothyroidism and the risk of cirrhosis and liver cancer in a group of patients with MASLD.
Jin X et al. Hypothyroidism and the risk of liver-related events in patients with metabolic dysfunction-associated steatotic liver disease. Clin Mol Hepatol 2026;32(1):353–367; doi: 10.3350/cmh.2025.0860. PMID: 41321024
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