Similarities and differences in follicular cell-derived thyroid cancer management guidelines used in Europe and the United States.

The management of thyroid cancer has become more refined and complex over the last thirty years. In an effort to provide guidance to both clinicians and patients, several organizations have developed clinical management guidelines that provide specific advice regarding the diagnosis, treatment and follow-up of differentiated thyroid cancer. In this review, we compare and contrast the major management recommendations provided in the guidelines of the European Thyroid Association with those published by thyroid cancer specialty organizations in the United States (American Thyroid Association and National Comprehensive Cancer Network). By carefully examining treatment and management approaches that are applied in other areas of the world, we can identify equally effective alternative treatment or follow-up options that may find applicability to specific patients in our own practice. Despite significant difference in cultures, economies, and health care delivery systems, thyroid cancer management recommendations from the European experts and the American experts are far more similar than they are different. Each of the guidelines strongly endorses an initial management approach that is guided by individualized estimates of risk of recurrence and risk of death. Furthermore, follow up and additional therapeutic recommendations are based on revised risk estimates that reflect an individual patient's response to therapy.