The impact of the media coverage on the thyroid cancer overdiagnosis issue concerning the surgical trends in South Korea, 2012-2017: a retrospective multicenter cohort study.

PURPOSE: This study aimed to evaluate changes in the extent of surgery and radioactive iodine (RAI) use in patients with papillary thyroid carcinoma (PTC) in South Korea between 2012 and 2017.

METHODS

A retrospective, multicenter cohort study was conducted using data from 15 tertiary hospitals. Variables included extent of thyroidectomy, lymph node dissection, and RAI use. Trends were evaluated annually. Patients with recurrent disease, non-PTC histology, or missing data were excluded, and temporal trends were assessed using linear-by-linear association.

RESULTS

Among 27,625 patients, total thyroidectomy decreased from 72.7% to 40.8%, while lobectomy increased from 27.1% to 57.3%. Central neck dissection remained >90%, while RAI use dropped from 41.4% to 17.4%. Tumor diameter gradually increased over time, with a shift toward higher tumor-node-metastasis stages.

CONCLUSION

A shift toward conservative surgery and reduced RAI use in patients with PTC reflects guideline-based deescalation of thyroid cancer treatment in South Korea. These findings demonstrate substantial changes in the real-world management of PTC across tertiary hospitals during the study period.