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Head Neck. 2019 Feb 21. doi: 10.1002/hed.25707. [Epub ahead of print]

Comparison of Bethesda cytopathology classification to surgical pathology across racial-ethnic groups.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
2
Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York.
3
Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York.
4
Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York.
5
Director, Rutgers Cancer Institute of New Jersey, Vice Chancellor for Cancer Programs, Rutgers Biomedical and Health Sciences, Senior Vice President, Oncology Services, RWJBarnabas Health, Professor of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
6
Associate Professor of Surgery, Chief, Section of Endocrine Surgery, Rutgers Cancer Institute of New Jersey, Associate Professor of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

Abstract

BACKGROUND:

The Bethesda System standardized the reporting of thyroid cytopathology and created categories to provide an estimation of a nodule's risk of malignancy. There are limited data describing their utility in different racial-ethnic groups.

METHODS:

A retrospective chart review of thyroid fine-needle aspirations (FNA) was performed within our health-care systems. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) were calculated for the total cohort, and racial-ethnic groups.

RESULTS:

The sensitivity, specificity, PPV, and NPV of the entire cohort was 93%, 77%, 57%, and 97%. Among patients who underwent surgery, African Americans contained a high number of Bethesda II FNAs (63%) compared to Hispanics (48%) and whites (45%). The sensitivity, specificity, and NPV were comparable among groups, the PPV was lowest for African Americans (43%), followed by Hispanics (60%) and whites (69%).

CONCLUSIONS:

The Bethesda system's predictive value may differ among racial-ethnic groups.

KEYWORDS:

Bethesda system; fine-needle aspiration biopsy; prevalence; test characteristics; thyroid

PMID:
30793405
DOI:
10.1002/hed.25707

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