Rosalind Franklin Society Proudly Announces the 2022 Award Recipient for Thyroid

American Thyroid Association guidelines recommend less extensive surgery and more restricted use of radioactive iodine (RAI) for low-risk papillary thyroid carcinoma (PTC), and active surveillance for select microcarcinomas. The impact of these recommendations remains unclear. Using SEER-18 cancer registry data, we described time trends in first-course treatment for 105,483 patients diagnosed with first primary, localized PTC. RAI use declined for PTCs <4 cm, including microcarcinomas. Total thyroidectomy alone increased, while lobectomy declined and then rose. Nonsurgical management was used for <1% of microcarcinomas annually. For pediatric patients (<20 years), RAI use peaked in 2009 then decreased to 11%, while total thyroidectomy alone and, to a lesser extent, lobectomy increased. No changes were observed for >= 4-cm PTCs. Trends in lobectomy and nonsurgical management were more subtle than expected; this may change as evidence regarding their safety continues to emerge.