{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:11:18Z","timestamp":1787008278342,"version":"build-2736575974"},"reference-count":38,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prior studies evaluating thyroid fine needle aspiration biopsies (FNABs) have limited the calculation of risk of malignancy (ROM) to cytologic specimens with corresponding histologic specimens, and clinical follow-up for those patients who do not undergo immediate surgery has been largely disregarded. Moreover, there is marked variability in how researchers have approached thyroid FNAB statistical analyses. This study addresses the urgent need for information from a large cohort of patients with long-term clinical follow-up to more accurately determine the performance of thyroid FNAB and ROM for each diagnostic category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of the University of California, San Francisco (UCSF), pathology database for thyroid FNABs from January 1, 1997, to December 31, 2004, was performed. Diagnoses were coded using the 2017 The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), and patients were matched to both the UCSF cancer registry and California Cancer Registry. Data were analyzed using the Kaplan\u2013Meier method, and stratified by TBSRTC diagnostic category. Kaplan\u2013Meier curves were used to estimate incidence rates of malignancy, stratified by FNAB category. Cox proportional hazards models were used to determine the instantaneous ROM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Initial FNABs from 2207 patients were included. Median follow-up period after the first thyroid FNAB was 13.9 years (range: 10.5\u201318.4 years). During follow-up, there were 279 confirmed diagnoses of thyroid malignancy. Estimates derived from Kaplan\u2013Meier curves demonstrated that the risk of having a thyroid malignancy was low for nondiagnostic and benign categories, intermediate for atypia of undetermined significance (AUS), follicular lesion of undetermined significance (FLUS), AUS\/FLUS combined, and follicular neoplasm, and high for suspicious and malignant categories. A total of 52\/1575 false-negative cases (3.2%) were identified. Excluding papillary microcarcinomas, the false-negative rate was 1.5% (23\/1575). No patients with a false-negative diagnosis died of thyroid cancer during the follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Asymptomatic patients with low-risk clinical and radiologic features and initially benign or unsatisfactory biopsy are unlikely to develop thyroid malignancy and highly unlikely to die of thyroid cancer. FNAB is highly accurate in detecting malignancy. Additional studies evaluating similar large data sets after the adoption of TBSRTC and the integration of molecular testing are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2020.0689","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:56:55Z","timestamp":1609203415000},"page":"1086-1095","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["A Large Thyroid Fine Needle Aspiration Biopsy Cohort with Long-Term Population-Based Follow-Up"],"prefix":"10.1177","volume":"31","author":[{"given":"Dianna L.","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Pathology, University of California, San Francisco, San Francisco, California, USA."},{"name":"Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA."},{"name":"Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemieke","family":"van Zante","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of California, San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Griffin","sequence":"additional","affiliation":[{"name":"Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy K.","family":"Hills","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, and University of California, San Francisco, San Francisco, California, USA."},{"name":"Department of Neurology, University of California, San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt-Marie","family":"Ljung","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of California, San Francisco, San Francisco, California, USA."},{"name":"Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_4_3_2","unstructured":"Howlader N Noone AM Krapcho M Miller D Brest A Yu M Ruhl J Tatalovich Z Mariotto A Lewis DR Chen HS Feuer EJ Cronin KA (eds) SEER Cancer Statistics Review 1975\u20132016 Bethesda MD based on November. 2018. 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