Active Surveillance or Surgery for Very Low Risk Papillary Thyroid Cancer: How Often are Disease Management Goals Met?


The risk of treating small, low risk papillary thyroid cancer (PTC) that is detected very early must be balanced with treatment risks, including those related to surgery to remove the thyroid gland, as well as potential life-long thyroid hormone treatment, and other treatments.

Close monitoring of cancer, with the plan to treat with surgery if it progresses, is called as active surveillance. There are some published long-term follow-up studies from Japan on the safety of AS in very low risk PTC.

In this study, we are offering eligible patients with small, low risk PTC, the option of active surveillance or surgery. We are examining the long-term outcomes, including how often patients in the surveillance group may avoid surgery for cancer progression and how often patients who choose surgery are cured (i.e. do not require additional PTC treatment). We are also examining patient-reported outcomes, including quality of life, mood, cancer survivor concerns, and feelings about disease management choice such as decision regret.


Currently recruiting participants: Yes

Eligible gender: Male, Female, Transgender, Other

Eligible ages: 18 to 100

Inclusion criteria:

You may be eligible for this study if you are:
1. Age 18 years old or older
2. Have never had thyroid surgery
3. Had a thyroid biopsy that shows PTC or is suspicious for PTC, the tumor is less than 2 cm in size and it is confined to the thyroid
4. Have no medical reasons that would preclude study participation or necessitate thyroid surgery
5. Are able to provide informed consent

Exclusion criteria:

You are not eligible for this study if you:
1. Currently pregnant
2. Have a thyroid cancer > 2 cm or your cancer has spread outside the thyroid
3. Have a non-papillary thyroid cancer
4. Have already had thyroid surgery in the past
5. Have other medical conditions that would prevent you from being able to receive thyroid surgery should your PTC grow during active surveillance


Fill out the following form if you want to participate in this research

Method of contact

Additional information

Contact information

Sana Ghaznavi, MD, FRCPC Endocrinology & Metabolism

Principal investigator:

Sana Ghaznavi

Clinical trial: