Fine needle aspiration of the thyroid: a contemporary experience of 3981 cases

Background: Fine needle aspiration (FNA) is an essential tool for the management of thyroid nodules. Recently, several national organizations have recommended FNA of all thyroid nodules >1 cm. With the increase use of imaging in the practice of medicine over the last decade, the number of incidentally discovered thyroid nodules is rising. Therefore, we analyzed our experience to determine if these changes in practice led to alterations in the population of patients undergoing FNA at our institution.

Materials and methods: Data were collected from 981 consecutive patients who underwent thyroid FNA at our institution between 2002 and 2009. Patients were divided in two groups: the early time period 2002-2005 (group 1) and later time period 2006-2009 (group 2). Data from the two groups were analyzed with t-test and χ(2) tests (SPSS, Inc., Chicago, IL).

Results: Comparing the groups, the number of FNAs performed in the later time period increased significantly by 250%. Patients in the later time period (group 2) were more likely to be female and were significantly older. With regard to FNA diagnoses, the number of benign FNAs increased, while the percentage of FNAs diagnosed as malignant and as follicular neoplasm decreased. There also appears to be an increase in the incidence of thyroiditis.

Conclusions: The use of thyroid FNA has markedly increased during this contemporary series. This rise in thyroid FNA appears to be due to biopsy of benign thyroid nodules. With time, more females and older patients have undergone FNA, possibly reflecting the increased use of imaging studies in this patient population.