Based on favorable results of the active surveillance conducted by Kuma Hospital and Cancer Institute Hospital of JFCR, active surveillance was acknowledged as one of the management strategies in Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules in 2010 (Edited by Japan Association of Endocrine Surgeons and the Japanese Society of Thyroid Surgery) on the premise that thorough explanation was given to the patient and consent was obtained. In 2015, active surveillance for low-risk papillary thyroid microcarcinoma has been also adopted in American Thyroid Association's Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer.Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L.: 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer Thyroid. 26(1):1-133, 2016  Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules in 2018 (published by Japan Association of Endocrine Surgeons and the Japanese Society of Thyroid Surgery), actively recommends active surveillance for low-risk papillary thyroid microcarcinoma.
