title: Fine-needle aspiration cytology: a survey of current utilization in relationship to hospital size, surgical pathology volume, and institution type.
abstract: Fine-needle aspiration cytology has become an accepted technique for the preoperative diagnosis of palpable and radiographically detected lesions at a wide variety of body sites. Little information exists regarding the degree of utilization of the technique in the general medical community. The present study investigated the number of fine-needle aspirations (FNAs) performed in relationship to hospital size, surgical pathology caseload, and type of hospital. Six hospitals from each state were selected at random (total of 300), and a survey was sent which requested the following information: hospital size, surgical pathology caseload, FNA volume, most common sites aspirated, change in FNA utilization over the last 5 years, and who was performing the needle aspirates. Usable responses were received from 133 institutions. The survey revealed that in 63% of institutions, FNAs were performed predominantly or exclusively by clinicians. An increase in number of FNAs performed was reported in 73% of institutions, while 11% reported a net decrease in FNA volume. The breast was the most common organ undergoing needle aspiration, followed by the thyroid and lung. For all hospitals, irrespective of size and type, FNA volume represented about 2.5% of the total surgical pathology volume. For nonacademic tertiary-care institutions, FNA represented approximately 1.2% of the surgical pathology caseload, and for academic tertiary-care institutions, FNA volume was approximately 3.6% of cases. The survey indicated that utilization of FNA continues to increase, is predominantly performed by clinicians, and represents a greater percentage of tissue examinations in academic tertiary-care institutions than in either community general hospitals or nonacademic tertiary-care institutions.
authors.affiliation: Department of Pathology, University of Utah School of Medicine, Salt Lake City 84132, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Gupta
authors.forename: E E
authors.initials: EE
authors.lastname: Mooney
authors.forename: L J
authors.initials: LJ
authors.lastname: Layfield
mesh_terms: D001707:Biopsy, Needle / Q000706:statistics & numerical data* / Q000639:trends; D006739:Hospital Administration; D006742:Hospital Bed Capacity; D006761:Hospitals / Q000145:classification / Q000592:standards / Q000639:trends*; D006801:Humans; D010340:Pathology, Surgical / Q000458:organization & administration; D011795:Surveys and Questionnaires