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In this meta\u2010analysis, we investigated the differences in diagnosis frequency, resection rate (RR), and risk of malignancy (ROM) between Western (ie, American and European) and Asian cytopathology practices. We searched PubMed and Web of Science from January 2010 to January 2019. Proportion and 95% CIs were calculated using a random\u2010effect model. We used independent sample <jats:italic>t<\/jats:italic> tests to compare frequencies, RR, and ROM between Western and Asian practices. We analyzed a total of 38 studies with 145,066 fine\u2010needle aspirations. Compared with Asian practice, Western series had a significantly lower ROM in most of TBSRTC categories, whereas the RR was not statistically different. Focusing on indeterminate nodules, the RR in Western series was significantly higher (51.3% vs 37.6%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.048), whereas the ROM was significantly lower (25.4% vs 41.9%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) compared with those in Asian series. The addition of Asian cohorts increased ROM for most of diagnostic categories compared with the original TBSRTC. In conclusion, this study demonstrates a difference in Western and Asian thyroid cytology practice, especially regarding the indeterminate categories. Lower RR and higher ROM suggest that Asian clinicians adopt a more conservative approach, whereas immediate diagnostic surgery is favored in Western practice for indeterminate nodules. The addition of Asian series into a meta\u2010analysis of TBSRTC altered ROM for several categories, which should be considered in future revisions of TBSRTC.<\/jats:p>","DOI":"10.1002\/cncy.22228","type":"journal-article","created":{"date-parts":[[2019,12,28]],"date-time":"2019-12-28T14:27:46Z","timestamp":1577543266000},"page":"238-249","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":120,"title":["Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6213-765X","authenticated-orcid":false,"given":"Huy Gia","family":"Vuong","sequence":"first","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanh Thi Tuyet","family":"Ngo","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Medicine and Pharmacy at Ho Chi Minh City Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4203-5696","authenticated-orcid":false,"given":"Andrey","family":"Bychkov","sequence":"additional","affiliation":[{"name":"Department of Pathology Kameda Medical Center Kamogawa City Japan"},{"name":"Department of Pathology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-3708","authenticated-orcid":false,"given":"Chan Kwon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Hospital Pathology College of Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang Huyen","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Pathology Oncology Hospital Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim Bach","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Pathology Oncology Hospital Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0347-7264","authenticated-orcid":false,"given":"Kennichi","family":"Kakudo","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Nara Hospital, Kindai University Faculty of Medicine Ikoma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0274"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0500"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ13-0494"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21703"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-014-0062-0"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339959"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0154-SA"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0110"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12515"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP161208.GL"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12491"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2018.12.01"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.4132\/jptm.2017.09.27"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39343.408449.80"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.4616"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22088"},{"key":"e_1_2_8_21_1","unstructured":"National Heart Lung and Blood Institute.Quality assessment tool for observational cohort and cross\u2010sectional studies.2014. 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