Thyroid nodules are common. Most are benign (i.e., not cancerous) and do not need to be treated. However, treatment may be needed when larger nodules lead to compressive symptoms (e.g., difficulty breathing or trouble swallowing) or when the nodules themselves produce thyroid hormone (called “autonomously functioning thyroid nodules” or AFTNs). Papillary thyroid cancer is the most common type of thyroid cancer and it may also need to be treated if there is a risk of the cancer growing or spreading.

Surgery is the usual treatment for thyroid nodules and papillary thyroid cancer, but it is invasive and comes with risks of complications. Ablative technologies (including radiofrequency, microwave, laser and high-intensity focused ultrasound ablation) use high temperature, chemicals, or electricity to shrink or remove the nodule. They do not require general anesthesia, a surgical incision, or removal of the thyroid gland, and they could be alternatives to surgery. 

This health technology assessment looked at how safe, effective and cost-effective ablative technologies are for adults with symptomatic benign thyroid nodules, cystic thyroid nodules, AFTNs, or small, low-risk papillary thyroid cancer. It also looked at the budget impact of publicly funding ablative technologies and at the experiences, preferences and values of patients with thyroid nodules.