Balancing the benefits and harms of thyroid cancer surveillance in survivors of Childhood, adolescent and young adult cancer: Recommendations from the international Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium

S C. Clement, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatric Endocrinology, Wilhelmina Children's Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands.
L C. Kremer, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
F A. Verburg, Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany.
J H. Simmons, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
M Goldfarb, Department of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
R P. Peeters, Department of Medicine/Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands; Rotterdam Thyroid Center, Erasmus Medical Center, Rotterdam, The Netherlands.
E K. Alexander, Thyroid Section, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
E Bardi, 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary.Follow
E Brignardello, Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
L S. Constine, Department of Radiation Oncology and Pediatrics, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
C A. Dinauer, Yale Pediatric Thyroid Center, Department of Surgery and Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
V M. Drozd, Department of Endocrinology, Belarusian Medical Academy of Post-Graduate Education, Minsk, Belarus.
F Felicetti, Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
E Frey, Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Vienna, Austria.
A Heinzel, Department of Nuclear Medicine, RWTH University Hospital Aachen, Aachen, Germany.
M M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
S A. Huang, Thyroid Program of the Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA.
T P. Links, University of Groningen, University Medical Center Groningen, Department of Endocrinology, The Netherlands.
K Lorenz, Department of General, Visceral and Vascular Surgery, University of Halle-Wittenberg, Halle (Saale), Germany.
R L. Mulder, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
S J. Neggers, Department of Medicine/Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands.
E J. Nieveen van Dijkum, Department of Pediatric Surgical Center Amsterdam, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
K C. Oeffinger, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
R R. van Rijn, Department of Radiology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
S A. Rivkees, Department of Pediatrics, University of Florida, Shands Children's Hospital, Gainesville, FL, USA.
C M. Ronckers, Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
A B. Schneider, Section of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, IL, USA.
R Skinner, Children's HSCT Unit, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
J D. Wasserman, Division of Endocrinology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
T Wynn, Department of Pediatrics, Division of Hematology/Oncology, University of Florida, USA.
M M. Hudson, Departments of Oncology and Epidemiology & Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
P C. Nathan, Division of Haematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
H M. van Santen, Department of Pediatric Endocrinology, Wilhelmina Children's Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: h.m.vansanten@umcutrecht.nl.

Abstract

Radiation exposure to the thyroid gland during treatment of childhood, adolescent and young adult cancer (CAYAC) may cause differentiated thyroid cancer (DTC). Surveillance recommendations for DTC vary considerably, causing uncertainty about optimum screening practices. The International Late Effects of Childhood Cancer Guideline Harmonization Group, in collaboration with the PanCareSurFup Consortium, developed consensus recommendations for thyroid cancer surveillance in CAYAC survivors. These recommendations were developed by an international multidisciplinary panel that included 33 experts in relevant medical specialties who used a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. Of the two available surveillance strategies, thyroid ultrasound and neck palpation, neither was shown to be superior. Consequently, a decision aid was formulated to guide the health care provider in counseling the survivor. The recommendations highlight the need for shared decision making regarding whether to undergo surveillance for DTC and in the choice of surveillance modality.

Publication Title

Cancer treatment reviews

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