{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:37:10Z","timestamp":1793295430693,"version":"4.5.0"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T00:00:00Z","timestamp":1572912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Bethesda system for cytopathology (TBSRTC) is a 6\u2010tier diagnostic framework developed to standardize thyroid cytopathology reporting. The aim of this study was to determine the risk of malignancy (ROM) for each Bethesda category.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thyroidectomy\u2010related data from 314 facilities in 22 countries were entered into the following outcome registries: CESQIP (North America), Eurocrine (Europe), SQRTPA (Sweden) and UKRETS (UK). Demographic, cytological, pathologic and extent of surgery data were mapped into one dataset and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 41,294 thyroidectomy patient entries from January 1, 2015, to June 30, 2017, 21,746 patients underwent both thyroid FNA and surgery. A comparison of cytology and surgical pathology data demonstrated a ROM for Bethesda categories 1 to 6 of 19.2%, 12.7%, 31.9%, 31.4%, 77.8% and 96.0%, respectively. Male patients had a higher rate of malignancy for every Bethesda category. Secondary analysis demonstrated a high ROM in male patients with Bethesda 3 category aged 31\u201335 years (52.1%, 95% confidence interval (CI) 37.9\u201366.2%), aged 36\u201340 years (55.9%, 95% CI 39.2\u201372.6%) and aged 41\u201345 years (46.9%, 95% CI 33\u201360.9%). Patients with Bethesda 5 and 6 scores were more likely to undergo total thyroidectomy (65.9% and 84.6%); for patients with Bethesda scores 2 and 3, a higher percentage of females underwent total thyroidectomy compared to males in spite of a higher ROM for males.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These data demonstrate that Bethesda categories 1\u20134 are associated with a higher ROM compared to the first edition of TBSRTC, especially in male patients, and validate findings from the second edition of TBSRTC.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05258-7","type":"journal-article","created":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T20:02:41Z","timestamp":1572984161000},"page":"426-435","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Correlating the Bethesda System for Reporting Thyroid Cytopathology with Histology and Extent of Surgery: A Review of 21,746\u00a0Patients from Four Endocrine Surgery Registries Across Two Continents"],"prefix":"10.1002","volume":"44","author":[{"suffix":"III","given":"William B.","family":"Inabnet","sequence":"first","affiliation":[{"name":"Department of Surgery University of Kentucky College of Medicine 800 Rose St, MN 268 40536 Lexington KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Palazzo","sequence":"additional","affiliation":[{"name":"Hammersmith Hospital and Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie Ann","family":"Sosa","sequence":"additional","affiliation":[{"name":"University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Kriger","sequence":"additional","affiliation":[{"name":"Columbia University Mailman School of Public Health New York NY 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Bergenfelz","sequence":"additional","affiliation":[{"name":"Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPPHLWMI3JV4LA"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000451020"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-60570-8_1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","unstructured":"TuttleRMRisk stratification in differentiated thyroid cancer: importance and clinical implications of preoperative risk stratification.VideoEndocrinology(2018)10.1089\/ve.2018.0140","DOI":"10.1089\/ve.2018.0140"},{"key":"e_1_2_7_7_1","unstructured":"HuangBJ ChabotJ LeeJA KuoJHA stepwise 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November 2019","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"None of the authors declare any conflict of interest except Dr. Sosa who declares the following disclosures: She is a member of the Data Monitoring Committee of the Medullary Thyroid Cancer Consortium Registry supported by GlaxoSmithKline, Novo Nordisk, Astra Zeneca, and Eli Lilly.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}