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

Amishav Bresler, Vikas Mehta, Bradley A. Schiff, Richard V. Smith, Samer Khader, Gloria Ramos-Rivera, Juan Lin, Steven K. Libutti, Amanda M. Laird, Thomas J. Ow

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2340-2345
Number of pages6
JournalHead and Neck
Issue number7
StatePublished - Jul 2019


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

ASJC Scopus subject areas

  • Otorhinolaryngology


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