ATA Releases First Guidelines for Thyroid Nodules, Thyroid Cancer in Children

The American Thyroid Association has released the first guidelines for evaluating and managing thyroid nodules and thyroid cancer in pediatric patients.

The American Thyroid Association (ATA) has published the first guidelines for the evaluation and management of thyroid nodules and thyroid cancer in pediatric patients, according to a press release.

Recommendations were based on an extensive literature review of clinical studies involving children and adolescents aged 18 years or younger. They address a number of topics, including the use of ultrasound and fine-needle aspiration to evaluate and manage benign thyroid nodules.

Additionally, recommendations on assessment, treatment and monitoring of children and adolescents with differentiated thyroid cancer tackle various pieces of management, including pre-operative staging, surgical management, the role of radioactive iodine therapy and the goals of thyrotropin suppression.

The guidelines also advocate a “broader scope of therapeutic options” for these pediatric patients with “the aim of limiting the use of aggressive therapy when it is unlikely to offer benefit,” the release states.

Previous ATA guidelines on thyroid nodules and thyroid cancer primarily focused on adults. Because of the potential differences in clinical presentation and long-term outcomes, as well as the possible risks associated with overly aggressive therapy in the pediatric population, the ATA charged a task force with drafting guidelines that targeted children.

The task force was led by Chair Gary Francis, MD, PhD, of Virginia Commonwealth University in Richmond and Co-Chairs Steven Waguespack, MD, of the University of Texas MD Anderson Center in Houston, and Andrew Bauer, MD, of Children’s Hospital of Philadelphia.

“These ATA guidelines fill an important gap and, for the first time, provide structured recommendations for the management of thyroid nodules and thyroid cancer in children. The guidelines specifically address the important differences in the biological behavior and management of these entities in children, and provide a much needed overview of the currently existing evidence,” Peter A. Kopp, MD, Editor-in-Chief of Thyroid and associate professor of medicine at Northwestern University Feinberg School of Medicine in Chicago, said in the release.

Look for a full-length feature on the guidelines from Endocrinology Advisor in the next few weeks.


  1. Francis GL et al. Thyroid. 2015;doi:10.1089/thy.2014.0460.