**12. Conclusions**

The current thyroid cancer 'pandemic' is caused primarily by small PTCs that may have caused no harm in most patients, if left undiagnosed. Regardless of the followed guidelines, healthcare, and insurance system, substantial resources are being used for the diagnosis, treatment, and follow-up of this potentially indolent condition. Increased healthcare costs and spending have placed significant pressure to identify potential factors associated with these increased costs and find solutions. The next decade will determine whether as clinicians we can reverse current trends in the ever-increasing cost of thyroid cancer care.
