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Due to the growing population of patients with low-risk papillary thyroid cancer, active surveillance is increasingly considered worldwide instead of immediate surgical intervention. The study is a short summary of the current knowledge on this subject from the European perspective. So far in Europe, the results of one Italian non-randomized prospective observational study with a relatively short followup (19 months) have been published. The study assessed a group of 93 patients with low advanced papillary thyroid cancer or with the suspicion of cancer (Bethesda V). The current study results are not different from those obtained in other parts of the world and confirm the possibility of safe active surveillance in a properly selected group of patients. The results also should prompt other experienced European centers to initiate such management. For example, the Danish researchers have recently conducted a retrospective analysis of a group of 803 patients whose aim was to assess the prevalence and course of papillary thyroid microcarcinoma depending on the method of cancer detection and the possibility of identification of patients who are eligible for active surveillance. When the possibility of introducing active surveillance to the therapeutic management of thyroid microcarcinoma in Europe is considered, several important aspects must be taken into account. These aspects include a higher prevalence of multinodular goiter and thyroiditis in the European population compared to American and Asian populations, differences in the organization and financing of healthcare systems in different countries, various aspects of legal regulations and a more conservative approach to the methods of treatment of malignancies among both patients and medical teams. It seems that currently in Europe active surveillance as a management option for low-risk papillary thyroid cancer should be considered. However, it ought to be conducted only by experienced centers as part of clinical programs.

European perspective on active surveillance for papillary thyroid microcarcinoma—are we ready?