The current detection rate of thyroid nodules is high, about 50% in the adult population by ultrasound and imaging, and a little lower in some populations, about 30% to 50%. In recent years, the incidence of thyroid cancer in China has increased significantly, and the incidence of thyroid cancer has been found in clusters, i.e. many patients with thyroid cancer are found in a certain unit or in a certain uniform physical examination. The important reason for this phenomenon is that a part of the population has microscopic thyroid cancer, i.e. occult thyroid cancer. This type of cancer grows very slowly and does not show any signs because it is small, but it is easily detected by ultrasound and other tests. It is important to note that the incidence of occult thyroid cancer in the population is a few percent, while the incidence of clinical thyroid cancer is a few in 100,000. This means that occult thyroid cancer is very common. The vast majority of occult thyroid cancers do not form clinical thyroid cancers. Most opinions suggest that premature intervention for these occult thyroid cancers can be avoided. Diagnostic measures for thyroid nodules and thyroid cancer The diagnosis of thyroid nodules and thyroid cancer is now well established and there are 3 main methods. The gold standard for diagnosis is fine needle aspiration cytology, which has a sensitivity and specificity of about 90%. Some international and domestic units have done a good job in this area. The second is ultrasound, which is non-invasive and free of radiation damage, and can be repeatedly checked and the size of the nodule or tumor can be observed to change during the follow-up. If malignancy is suspected, further fine needle aspiration can be performed. If a hot nodule with function is suspected, radionuclide scan can be preferred. If the nodule is determined to be a thermal nodule, it is clear that it is a benign lesion and thus no further testing is necessary. The third method is the molecular diagnosis of the tumor or nodule. Many malignant tumors contain oncogenes, as does thyroid cancer. If a genetic test reveals a positive oncogene, it helps to diagnose a malignant tumor. In terms of treatment, for very small, isolated nodules less than 1 cm and also without extra-thyroidal metastasis, thyroidectomy on one side is sufficient and no further treatment is needed; regular follow-up and observation is sufficient. For large nodules of 1-2 cm or more, with lymph node metastasis or extrathyroidal metastasis, including distant metastasis, they must be completely removed, followed by I131 ablation therapy to eliminate all metastatic lesions. treatment guidelines. Most of thyroid cancers are differentiated type, so most of them can be cured through treatment. Most thyroid cancers can be cured with treatment, and most of them can be cured with early diagnosis and standardized treatment. Overtreatment of thyroid nodules At present, the overtreatment of thyroid nodules is indeed very serious, mainly because the nodules are not well evaluated before surgery and the important diagnostic cytology of thyroid biopsy is not widely performed. In addition, clinical management of thyroid nodules is based only on past experience and intuition, without the use of modern diagnostic tools for evaluation, fearing that they are malignant tumors, and surgical treatment when encountering thyroid nodules. Therefore, we urgently need to establish a standard of care for thyroid nodules in China. All nodules need to be critically evaluated before treatment, especially before invasive treatment. If it is determined to be a malignant nodule or if it is still indistinguishable from benign or malignant after such a rigorous evaluation, then surgical treatment can be undertaken. If it is evaluated as benign, follow-up is sufficient. At present, the problem is still serious in our country, and we hope to draw your attention to minimize the negative impact of this problem.