Thyroid nodules, with a prevalence of almost 25% in the general population, are a common occurrence. Their prevalence varies considerably depending on demographics such as age and sex as well as the presence of risk factors. This article provides a comprehensive overview of the prevalence, risk stratification and current management strategies for thyroid nodules, with a particular focus on changes in diagnostic and therapeutic protocols that have occurred over the past 10 years. Several sonography-based stratification systems (such as Thyroid Imaging Reporting and Data Systems (TIRADS)) might help to predict the malignancy risk of nodules, potentially eliminating the need for biopsy in many instances. However, large or suspicious nodules necessitate cytological evaluation following fine-needle aspiration biopsy for accurate classification. In the case of cytology yielding indeterminate results, additional tools, such as molecular testing, can assist in guiding the management plan. Surgery is no longer the only treatment for symptomatic or malignant nodules: active surveillance or local ablative treatments might be beneficial for appropriately selected patients. To enhance clinician–patient interactions and discussions about diagnostic options, shared decision-making tools have been developed. A personalized, risk-based protocol promotes high-quality care while minimizing costs and unnecessary testing.

甲状腺结节在普通人群中的患病率接近 25%，是一种常见的情况。它们的患病率因年龄和性别等人口统计数据以及风险因素的存在而有很大差异。本文全面概述了甲状腺结节的患病率、风险分层和当前管理策略，特别关注过去 10 年诊断和治疗方案的变化。几种基于超声的分层系统（如甲状腺成像报告和数据系统 （TIRADS））可能有助于预测结节的恶性肿瘤风险，在许多情况下可能无需活检。然而，大结节或可疑结节需要在细针穿刺活检后进行细胞学评估，以便准确分类。如果细胞学检查结果不确定，其他工具（例如分子检测）可以帮助指导管理计划。手术不再是症状性或恶性结节的唯一治疗方法：主动监测或局部消融治疗可能对适当选择的患者有益。为了加强临床医生与患者的互动和关于诊断方案的讨论，已经开发了共享决策工具。基于风险的个性化方案可促进高质量护理，同时最大限度地降低成本和不必要的测试。