{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:17:36Z","timestamp":1781885856873,"version":"3.54.5"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to assess treatment preferences among newly diagnosed low-risk papillary thyroid microcarcinoma (PTMC) patients and analyse the trade-offs they make in treatment decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Conducted at the Fourth Affiliated Hospital of Harbin Medical University from June 2023 to April 2024, this study employed a discrete choice experiment. Participants were asked to choose among three treatment options with varying levels across seven attributes. A mixed logit model was used to analyse patient preferences, calculate the relative importance (RI) of attributes, and estimate marginal willingness to pay (mWTP). Subgroup analyses were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final sample of 418 participants yielded 11,286 observations. The most influential attribute affecting treatment choice was the 10-year risk of disease recurrence or progression (RI\u202f=\u202f58.4%), followed by the risk of short-term complications (RI\u202f=\u202f8.9%), treatment type (RI\u202f=\u202f8.5%), length of hospital stay (RI\u202f=\u202f7.7%), need for lifelong thyroid medication (RI\u202f=\u202f7.3%), and out-of-pocket treatment costs (RI\u202f=\u202f6.9%). The risk of permanent voice change had minimal impact (RI\u202f=\u202f2.4%). Regarding treatment type, participants significantly preferred thermal ablation over open surgery, while endoscopic thyroidectomy was less preferred, and active surveillance was the least favoured option. The mWTP analysis reinforced these priorities. Additionally, sociodemographic and psychological factors also influenced preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the need for healthcare providers to clearly communicate the long-term impacts of different treatment options to support informed decision-making. They also underscore the importance of improving patient-centred care, enhancing health education, and addressing the issue of overtreatment in PTMC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1686729","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:56:15Z","timestamp":1765886175000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment preferences in low-risk papillary thyroid microcarcinoma: a discrete choice experiment"],"prefix":"10.3389","volume":"13","author":[{"given":"Siming","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialiang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfeng","family":"Yue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqin","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo","family":"Miao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"941","DOI":"10.3390\/curroncol31020070","article-title":"Papillary thyroid microcarcinoma: papillary thyroid microcarcinoma: differences between lesions in incidental and nonincidental settings-considerations on these clinical entities and personal experience","volume":"31","author":"Lucandri","year":"2024","journal-title":"Curr Oncol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1016\/S2213-8587(20)30115-7","article-title":"Global trends in thyroid cancer incidence and the impact of overdiagnosis","volume":"8","author":"Li","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/S2213-8587(20)30372-7","article-title":"Thyroid cancer in the USA: current trends and outstanding questions","volume":"9","author":"Davies","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref4","volume-title":"WHO classification of Tumours: Head and Neck Tumours","year":"2024"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1097\/SLA.0000000000000925","article-title":"Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients","volume":"260","author":"Adam","year":"2014","journal-title":"Ann Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s12020-023-03510-8","article-title":"Mortality rate and causes of death in papillary thyroid microcarcinoma","volume":"83","author":"Heo","year":"2024","journal-title":"Endocrine"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.amjsurg.2024.03.004","article-title":"The overtreatment of papillary thyroid microcarcinoma in the community","volume":"233","author":"Abraham","year":"2024","journal-title":"Am J Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/j.amjsurg.2021.08.015","article-title":"Total thyroidectomy can be overtreatment in cN1a papillary thyroid carcinoma patients whose tumor is smaller than 1 cm","volume":"223","author":"Back","year":"2022","journal-title":"Am J Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"203","DOI":"10.20892\/j.issn.2095-3941.2017.0051","article-title":"2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma","volume":"14","author":"Gao","year":"2017","journal-title":"Cancer Biol Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1007\/s12020-020-02441-y","article-title":"2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS","volume":"70","author":"Zhou","year":"2020","journal-title":"Endocrine"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s12020-022-02991-3","article-title":"Economic effect between surgery and thermal ablation for patients with papillary thyroid microcarcinoma: a systemic review and meta-analysis","volume":"76","author":"Chen","year":"2022","journal-title":"Endocrine"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1007\/s12020-024-04034-5","article-title":"Effects of endoscopic lobectomy and conventional lobectomy on psychological and sleep quality in patients with papillary thyroid microcarcinoma: a prospective observational study","volume":"87","author":"Jiang","year":"2025","journal-title":"Endocrine"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1016\/j.asjsur.2023.12.037","article-title":"Comparison of the effectiveness and safety between endoscope-assisted and traditional open surgery in the treatment of thyroid micropapillary carcinoma: a meta-analysis","volume":"47","author":"Wang","year":"2024","journal-title":"Asian J Surg"},{"key":"ref14","first-page":"7907","article-title":"Transoral endoscopic thyroidectomy vestibular approach for papillary thyroid microcarcinoma: an analysis of clinical outcomes","volume":"14","author":"Yan","year":"2022","journal-title":"Am J Transl Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1097\/SLA.0000000000005800","article-title":"Long-term outcomes of ultrasound-guided thermal ablation for the treatment of solitary low-risk papillary thyroid microcarcinoma: a multicenter retrospective study","volume":"277","author":"Yan","year":"2023","journal-title":"Ann Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2704087","DOI":"10.1155\/2024\/2704087","article-title":"Retrospective analysis of the efficacy and safety of ultrasound-guided radiofrequency ablation in the treatment of papillary thyroid microcarcinoma: a follow-up study of continuous postoperative surveillance and large-sample data","volume":"2024","author":"Zhou","year":"2024","journal-title":"Int J Endocrinol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1089\/thy.2023.0076","article-title":"Long-term outcomes of active surveillance and immediate surgery for adult patients with low-risk papillary thyroid microcarcinoma: 30-year experience","volume":"33","author":"Miyauchi","year":"2023","journal-title":"Thyroid"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1089\/thy.2021.0614","article-title":"Progression of low-risk papillary thyroid microcarcinoma during active surveillance: interim analysis of a multicenter prospective cohort study of active surveillance on papillary thyroid microcarcinoma in Korea","volume":"32","author":"Lee","year":"2022","journal-title":"Thyroid"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"bvad063","DOI":"10.1210\/jendso\/bvad063","article-title":"Active surveillance may be the best initial management for papillary thyroid microcarcinoma","volume":"7","author":"Ito","year":"2023","journal-title":"J Endocr Soc"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1166433","DOI":"10.3389\/fendo.2023.1166433","article-title":"Cost-effectiveness of active surveillance versus early surgery for thyroid micropapillary carcinoma based on diagnostic and treatment norms in China","volume":"14","author":"Lai","year":"2023","journal-title":"Front Endocrinol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1038\/s41467-025-57627-7","article-title":"A multicenter cohort study of thyroidectomy-related decision regret in patients with low-risk papillary thyroid microcarcinoma","volume":"16","author":"Li","year":"2025","journal-title":"Nat Commun"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1089\/thy.2019.0590","article-title":"Patient preferences around extent of surgery in low-risk thyroid cancer: a discrete choice experiment","volume":"30","author":"Ahmadi","year":"2020","journal-title":"Thyroid"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"A27","DOI":"10.1136\/bmjebm-2018-111070.60","article-title":"60 preferences for papillary thyroid cancer management and the impact of terminology: a discrete choice experiment","volume":"23","author":"Nickel","year":"2018","journal-title":"BMJ Evid Based Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1089\/thy.2019.0592","article-title":"A prospective mixed-methods study of decision-making on surgery or active surveillance for low-risk papillary thyroid cancer","volume":"30","author":"Sawka","year":"2020","journal-title":"Thyroid"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1007\/s10198-018-0954-6","article-title":"How well do discrete choice experiments predict health choices? A systematic review and meta-analysis of external validity","volume":"19","author":"Quaife","year":"2018","journal-title":"Eur J Health Econ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1007\/s40273-018-0734-2","article-title":"Discrete choice experiments in health economics: past, present and future","volume":"37","author":"Soekhai","year":"2019","journal-title":"PharmacoEconomics"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jval.2016.04.004","article-title":"Statistical methods for the analysis of discrete choice experiments: a report of the ISPOR conjoint analysis good research practices task force","volume":"19","author":"Hauber","year":"2016","journal-title":"Value Health"},{"key":"ref28","article-title":"Best practices for survey research","volume-title":"AAPOR","year":""},{"key":"ref29","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1177\/109442810141004","article-title":"Validation of a new general self-efficacy scale","volume":"4","author":"Chen","year":"2001","journal-title":"Organ Res Methods"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1207\/s15327752jpa5503&4_17","article-title":"Psychometric characteristics of the multidimensional scale of perceived social support","volume":"55","author":"Zimet","year":"1990","journal-title":"J Pers Assess"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"274","DOI":"10.13109\/zptm.2006.52.3.274","article-title":"Fear of progression in breast cancer patients-validation of the short form of the fear of progression questionnaire (FoP-Q-SF)","volume":"52","author":"Mehnert","year":"2006","journal-title":"Z Psychosom Med Psychother"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1186\/s12889-023-15237-2","article-title":"Validity and reliability of the Chinese version of the health literacy scale short-form in the Chinese population","volume":"23","author":"Sun","year":"2023","journal-title":"BMC Public Health"},{"key":"ref33","first-page":"1","volume-title":"Getting the most from CBC. Research paper series","author":"Johnson","year":"2003"},{"key":"ref34","first-page":"58","volume-title":"Sample size issues for conjoint analysis studies","author":"Orme","year":"1998"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1586\/14737167.2015.1033406","article-title":"Discrete-choice experiments versus rating scale exercises to evaluate the importance of attributes","volume":"15","author":"Wijnen","year":"2015","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"10732748221135447","DOI":"10.1177\/10732748221135447","article-title":"The incidence trend of papillary thyroid carcinoma in the United States during 2003-2017","volume":"29","author":"Li","year":"2022","journal-title":"Cancer Control"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1089\/thy.2019.0420","article-title":"Patients' view on the management of papillary thyroid microcarcinoma: active surveillance or surgery","volume":"30","author":"Yoshida","year":"2020","journal-title":"Thyroid"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"106917","DOI":"10.1016\/j.ejso.2023.04.016","article-title":"Active surveillance versus immediate surgery: a comparison of clinical and quality of life outcomes among patients with highly suspicious thyroid nodules 1 cm or smaller in China","volume":"49","author":"Liu","year":"2023","journal-title":"Eur J Surg Oncol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1089\/thy.2023.0058","article-title":"Hear the patient's voice regarding implementation of thyroid cancer active surveillance in China","volume":"33","author":"Wang","year":"2023","journal-title":"Thyroid"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1686729\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T14:30:05Z","timestamp":1765895405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1686729\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":39,"alternative-id":["10.3389\/fpubh.2025.1686729"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1686729","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,15]]},"article-number":"1686729"}}