Iodine or Not for Low-risk Differentiated Thyroid Cancer: How Should We Implement the Findings into UK Practice? An Expert Consensus Opinion.

[AIMS] To develop a national consensus on how to implement findings of recent practice changing Iodine or Not (IoN) trial.

[MATERIALS AND METHODS] A multidisciplinary group of UK clinicians specialising in the management of thyroid cancer was convened to discuss the impact of the IoN trial on the management of early stage, low risk differentiated thyroid cancer in the UK. Virtual meetings were held to discuss the trial data and to develop a position statement on how to implement the findings ahead of changes in national guidelines.

[RESULTS] A position statement providing recommendations for the managemnet of early stage, low risk differentiated thyroid cancer based on the group consensus opinion and interpretation of the IoN trial data was defined.

[CONCLUSION] The Iodine or Not (IoN) trial was a UK multicentre prospective randomised controlled trial that investigated the role of radioiodine ablation in early stage, low-risk differentiated thyroid cancer. The findings showed non-inferiority of omitting radioiodine in terms of recurrence-free survival. This provides level 1 evidence to support sparing many patients with low-risk thyroid cancer treatment with radioiodine and the possible associated treatment-related adverse events. Ahead of changes in national and international guidelines this multidisciplinary group of specialists involved in the management of thyroid cancer proposes a position statement on how to implement these findings into UK practice.