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

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.

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