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Most PTC lesions are asymptomatic and remain subclinical throughout life, and active surveillance is now being used to monitor the progression of these lesions and intervene when appropriate. This evidence synthesis aims to assess PTC progression in size over time during active surveillance in terms of PTC tumor size progression to or beyond 3\u2009mm during the surveillance period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A dose\u2013response meta\u2010analysis was conducted using the robust error meta\u2010regression method, using time as the \u201cdose\u201d and cumulative progression (%) was assessed. A comprehensive literature review was done using PubMed\/MEDLINE and EMBASE from inception till August 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 21 studies from 7 different countries, including 14\u2009648 participants, were included. Incident progression at 2\u2009years of follow\u2010up was 1%, and this increased linearly to 12% at 20\u2009years of follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It was concluded that progression over the threshold increases linearly over time at approximately less than 1% per year. Therefore, size progression beyond the threshold occurs in a minority and in less than one eighth of subjects by two decades of follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70183","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:22:16Z","timestamp":1748334136000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Size Increment During Surveillance in Papillary Thyroid Cancer: Evidence Synthesis and Dose\u2013Response Meta\u2010Analysis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-9101","authenticated-orcid":false,"given":"Mohamed Badie","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Population Medicine, College of Medicine, QU Health Qatar University  Doha Qatar"},{"name":"Department of Plastic Surgery Hamad General Hospital, Hamad Medical Corporation  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emad","family":"Naem","sequence":"additional","affiliation":[{"name":"Endocrinology Department Hamad General Hospital, Hamad Medical Corporation  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harman","family":"Saman","sequence":"additional","affiliation":[{"name":"Department of Medicine Hazm Mebaireek Hospital, Hamad Medical Corporation  Doha Qatar"},{"name":"Kent Oncology Center  Kent UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abeer","family":"Alsherawi","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, College of Medicine, QU Health Qatar University  Doha Qatar"},{"name":"Department of Plastic Surgery Hamad General Hospital, Hamad Medical Corporation  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asma","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, College of Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noora","family":"Al\u2010Abdulla","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, College of Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Latifa","family":"Alkaabi","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, College of Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud A.","family":"Zirie","sequence":"additional","affiliation":[{"name":"Endocrinology Department Hamad General Hospital, Hamad Medical Corporation  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhail A.","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, College of Medicine, QU Health Qatar University  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1409841"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/965212"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21332"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0359-x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0367"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-4026"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1990.tb01559.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.67.7419"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850801)56:3<531::AID-CNCR2820560321>3.0.CO;2-3"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0344-0338(11)80172-X"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-17-0397"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-003-6903-1"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0303-0"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.11.011"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.01.012"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.02.011"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000132"},{"key":"e_1_2_12_22_1","unstructured":"L.Furuya\u2010Kanamori C.Xu andS. 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