1.1. The need for guidelines
In spite of advances in diagnostic methods, surgical techniques
and clinical care, there are differences in survival of patients with
thyroid cancer in different countries, and the outcome in the UK
prior to 1989 appeared to be worse than in other western Euro-
pean nations.
1
The reasons for this are unclear and may be multi-
factorial. There is a sense that outcomes in the UK are improving,
but only long term national registry data can confirm or refute
this in future. However, it may not be unreasonable to speculate
that the impact of previous editions of these guidelines, and recent
changes in cancer services within the National Health Service may
have contributed. These include mandatory specialist multidisci-
plinary team management of all cancers (http://www.mycancer-
treatment.nhs.uk/wp-content/themes/mct/uploads/2012/09/resou
rces_measures_HeadNeck_Measures_April2011.pdf), regular ma
ndatory national peer review, equity of access to specialist care,
the cancer drug fund, national cancer research groups supporting
trials, patient support groups, national audits by professional or-
ganisations, the cancer reform strategy and survivorship pro-
gramme. It is hoped that the third edition of the national
guidelines for thyroid cancer, and their implementation through
local protocols of the NHS networks, will continue to facilitate this
process and improve care and outcomes in the UK