Background Well-differentiated thyroid cancer (WDTC) is a prevalent disease, which is increasing in incidence faster than any other cancer. Substantial direct medical care costs are related to the diagnosis and treatment of newly diagnosed patients as well as the ongoing surveillance of patients who have a long life expectancy. Prior analyses of the aggregate healthcare costs attributable to WDTC in the U.S. have not been reported. Methods A stacked cohort cost analysis was performed on the U.S. population from 1985-2013 to estimate the number of WDTC survivors in 2013. Incidence rates, cancer-specific, and overall survival were based on Surveillance, Epidemiology, and End Results data. We then estimated current and projected direct medical care costs attributable to the care of WDTC patients. Health-care related costs and event probabilities were based on Medicare reimbursement schedules and the literature. Results Estimated overall societal cost of WDTC care in 2013 for all U.S. patients diagnosed after 1985 is $1.6 billion. Diagnosis, surgery, and adjuvant therapy for newly diagnosed patients (41%) constitutes the greatest proportion of costs, followed by surveillance of survivors (37%) and non-operative deaths costs attributable to thyroid cancer care (22%). Projected 2030 costs (in 2013 $US) based on current incidence trends exceed $3.5 billion. Conclusion Healthcare costs of WDTC are substantial. Unlike other cancers, the majority of the cost is incurred in the initial and continuing phases of care. With the projected increasing incidence, population, and survival trends, costs will continue to escalate.

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This meta-analysis shows that BRAF mutational status correlates with recurrence of PTMCs, highlighting the potential utility of genotyping in preoperative and postoperative planning. BRAF mutation may be helpful in risk-stratifying patients with PTMC for surgical management versus observation.

Laparoscopic adrenalectomy remains safe for most adrenal disorders. Patient comorbidities, adrenal pathology, and tumor size are associated with the risk of complications and length of stay and should all be considered in selecting and preparing patients for surgery.