ECEESPE2025 Poster Presentations Thyroid (141 abstracts)
Nationwide web-survey on implementing the 2023 ETA guidelines for thyroid nodule management
Eleni Sazakli 1 , Olga Karapanou 2 , Grigoris Effraimidis 3 , Gerasimos Sykiotis 4 , Katerina Saltiki 5 & Marina Michalaki 1
1Faculty of Medicine, School of Health Science, University of Patras, Patras, Greece; 2Endocrine Department, NIMTS Veteran’s Hospital, Athens, Greece; 3Faculty of Medicine, School of Health Sciences, University of Thessaly, Department of Endocrinology and Metabolic Diseases, University General Hospital of Larissa, Larissa, Greece; 4Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; 5Endocrine Unit, Department of Clinical Therapeutics, National and Kapodistrian University, Athens, Greece
JOINT575
Background: Thyroid nodules are very common, and the European Thyroid Association (ETA) recently issued high-quality guidelines to standardize their management. However, the extent of guideline implementation and the barriers to adherence remain unclear. This study evaluates the application of the guidelines and identifies obstacles to their adoption among Greek endocrinologists.
Methods: Between November 2023 and April 2024, members of the Hellenic Endocrine Society (HES) completed a web-based survey on the management of a 2.5 cm thyroid nodule with fine-needle aspiration (FNA) cytology results of Atypia of Undetermined Significance (AUS). The scenarios varied by the nodule’s sonographic risk classification: intermediate (EU-TIRADS 4) or high (EU-TIRADS 5). Participants also provided demographic information and reasons for non-adherence to the guidelines.
Results: The survey had a 25% response rate. For an EU-TIRADS 4 nodule with AUS cytology, 61% of respondents chose to repeat FNA, while only 23% opted to do so for an EU-TIRADS 5 nodule with AUS cytology, despite the 2023 ETA guidelines recommending repeat FNA in both scenarios. More experienced endocrinologists were less likely to select repeat FNA and more inclined toward total thyroidectomy in the EU-TIRADS 4 scenario. In contrast, experience had no significant impact on decision-making for the EU-TIRADS 5 scenario. Key barriers to guideline adherence included skepticism about the recommendations, limited access to reliable neck ultrasonography and molecular testing, and a shortage of high-volume surgeons.
Conclusions: Greek endocrinologists frequently deviate from the 2023 ETA guidelines for managing thyroid nodules with indeterminate cytology, citing challenges that may also affect clinicians in other countries. These findings highlight the importance of developing strong implementation strategies alongside guideline releases, particularly in anticipation of the upcoming American Thyroid Association guidelines for managing thyroid nodules in adults.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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