PURPOSE OF REVIEW Thyroid cancer incidence and mortality trends have been identified as being consistent with overdiagnosis, and several recent efforts have been made to mitigate this problem. RECENT FINDINGS Major guidelines for thyroid nodule management recommend against general biopsy of nodules less than 1 cm in size. Data supporting the safety of active surveillance of low-risk thyroid cancers is now recognized. Tumors previously labeled as encapsulated follicular variant papillary thyroid cancers are now recommended to be called noninvasive follicular thyroid neoplasm with papillary-like nuclear features. SUMMARY Workup, diagnostic, and management of papillary thyroid cancer are changing rapidly to accommodate the recognition that many thyroid cancers are low risk and do not require aggressive, immediate intervention.