We read with interest the paper by Prof. Kim and Shong, entitled “Active surveillance of papillary thyroid microcarcinoma: a mini-review from Korea,” published in the December 2017 issue of Endocrinology and Metabolism (Seoul) [1]. Overdetection and overtreatment are common in many areas of modern medicine. Several steps are needed to decrease overdetection: elderly subjects who are unlikely to benefit should not be screened, biopsies should not be performed without a compelling reason, the screening interval should be stratified by risk, and the focus should be on screening subjects at high risk for disease progression [12]. Treatment should be tailored to the biological characteristics of the tumor and the patient's characteristics, and active surveillance (AS) should be offered to eligible patients with low-risk tumors, especially small-volume disease, as the first step in management [123]. Many low-grade papillary microcarcinomas are unlikely to progress to clinical symptoms, and pose a limited risk of death if left untreated [2]. Several AS criteria have been suggested for delayed treatment [4]. Although the upgrading and/or upstaging of cancer is a limitation of AS, recent reports have shown low rates of cancer-specific mortality [4].