Low-risk thyroid cancer: surgery or active surveillance—an application of shared decision-making: a narrative review

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Purpose: Shared decision-making (SDM) is a collaborative process in which patients and healthcare providers exchange medical information regarding treatment options and reach an optimal decision that reflects the patient’s values and preferences. In managing low-risk thyroid cancer, both surgery and active surveillance are valid treatment options, making SDM essential.Current Concepts: Although both surgery and active surveillance for low-risk thyroid cancer yield excellent long-term outcomes, each option has distinct advantages and disadvantages. The optimal treatment choice depends on the patient’s unique values, preferences, and clinical circumstances. Effective SDM in this setting requires active engagement from both patients and healthcare providers, interactive information exchange regarding treatment options and patient preferences, integration of patient values into the decision-making process, and, ultimately, agreement on a mutually acceptable treatment plan. To facilitate this process in practice, we applied a six-step SDM model and developed decision aids specifically tailored for patients with low-risk thyroid cancer.Discussion and Conclusion: SDM is expected to improve patient satisfaction with both the decision-making process and treatment outcomes, while reducing unnecessary interventions and decisional regret, thereby advancing truly patient-centered care.

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