Trends in thyroid fine-needle aspiration cytology practices: Results from a college of American pathologists 2016 practice survey

Daniel D. Mais, Barbara A. Crothers, Diane Davis Davey, Kristen E. Natale, Ritu Nayar, Rhona J. Souers, Barbara J. Blond, Sarah Hackman, Joseph A. Tworek

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Context.-The College of American Pathologists periodically surveys laboratories to determine changes in cytopathology practices. We report the results of a 2016 survey concerning thyroid fine-needle aspiration (FNA). Objective.-To provide a cross-sectional survey of thyroid cytology practices in 2016. Design.-In 2016, a survey was sent to 2013 laboratories participating in the College of American Pathologists Non-Gynecologic Cytology Education Program (NGC-A) requesting data from 2015-2016 on several topics relating to thyroid FNA. Results.-A total of 878 laboratories (43.6% of 2013) replied to the survey. Radiologists performed the most thyroid FNA procedures in most laboratories (70%; 529 of 756), followed by endocrinologists (18.7%; 141 of 756), and most of these were performed under ultrasound guidance (92.1%; 699 of 759). A total of 32.6% of respondents (251 of 769) provided feedback on unsatisfactory rates for nonpathology providers who performed FNA. Intraprocedural adequacy assessment was primarily performed by attending pathologists (77.4%; 490 of 633) or cytotechnologists (28.4%; 180 of 633). Most laboratories used the Bethesda System for Reporting Thyroid Cytopathology (89.8%; 701 of 781) and performed molecular testing based on clinician request (68.1%; 184 of 270) rather than FNA diagnosis. Correlation of thyroid excisions with prior cytology results most often occurred retrospectively (38.4%; 283 of 737) and was used for pathologist interpretive quality assurance purposes. Conclusions.-These survey results offer a snapshot of national thyroid FNA cytology practices in 2016 and indicate that standardized cytology terminology is commonly used; pathologists perform most immediate adequacy assessments for thyroid FNA; laboratories use correlation statistics to evaluate pathologists' performance; and molecular tests are increasingly requested for indeterminate interpretations, but reflex molecular testing is rare.

Original languageEnglish (US)
Pages (from-to)1364-1372
Number of pages9
JournalArchives of Pathology and Laboratory Medicine
Issue number11
StatePublished - 2019

ASJC Scopus subject areas

  • Medical Laboratory Technology
  • Pathology and Forensic Medicine


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