Evolution of Follow-up Strategies in Differentiated Thyroid Cancer: a Comparative Review of the 2015 ATA, 2024 KTA, and 2025ATA Guidelines
10.11106/ijt.2026.19.1.41
- Author:
Mijin KIM
1
;
Bo Hyun KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
- Publication Type:REVIEW ARTICLES
- From:International Journal of Thyroidology
2026;19(1):41-47
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recent updates in international guidelines have introduced important changes in the follow-up management of differentiated thyroid cancer (DTC). This review compares the 2015 American Thyroid Association (ATA), 2024 Korean Thyroid Association (KTA), and 2025 ATA guidelines across key domains, including initial risk stratification, TSH suppression, dynamic risk stratification, and long-term surveillance. The 2024 KTA and 2025 ATA guidelines show similar trends toward more individualized and risk-adapted follow-up strategies, incorporating cumulative risk assessment and dynamic response to therapy in place of fixed, factor-based criteria. Both guidelines adopt risk-adapted TSH targets with a shift toward less intensive suppression; however, the 2025 ATA guidelines substantially simplify the TSH target framework. Differences are also observed in the interpretation of serum thyroglobulin, particularly in patients managed without radioactive iodine or after lobectomy. In long-term surveillance, both guidelines recognize that patients with a sustained excellent response have a very low risk of late recurrence, and the 2025 ATA guidelines further incorporate considerations for reducing follow-up intensity in selected patients. Overall, these guidelines support adjustment of management according to ongoing risk and clinical context, while differing in how these principles are implemented in clinical practice.
