In 2006, three major society-endorsed guidelines and consensus reports on the diagnosis and management of thyroid nodules were published by the American Association of Clinical Endocrinologists/Associazone Medici Endocrinologi (AACE/AME), the American Thyroid Association (ATA) and the European Thyroid Association (ETA). Despite many similarities and areas with lack of evidence, significant differences between these guidelines are also present, reflecting differences in disease epidemiologies, practice patterns, interpretation of existing data, and the availability of resources in different regions. Some of these differences have been highlighted by several recent surveys among members of these organisations.
The major areas of disagreement between the guidelines concern the indication for scintigraphy, TSH cut off values, the use of fine needle aspiration cytology and of calcitonin determination in the differential diagnosis of thyroid nodules and the role of ultrasound in the follow up and treatment of benign thyroid nodules.
These guideline differences currently do contribute to confusion among practicing endocrinologists. However, they should also be used to further focus and advance our discussion of diagnostic and therapeutic strategies, the outline of future studies and also the elaboration of international guidelines for the diagnosis and treatment of thyroid nodules.
03 - 07 May 2008
European Society of Endocrinology