title: The Bethesda System thyroid diagnostic categories in the African-American population in conjunction with surgical pathology follow-up.
abstract: BACKGROUND
  It has been reported that African-Americans (AA) have a higher prevalence of overall malignancy compared to Caucasians, in the United States, yet the incidence of thyroid malignancy is half. The aim of this study is to assess the rate of malignant versus benign thyroid disease in AA from an urban-based hospital with an academic setting. Our study analyzed the AA population with respect to fine needle aspiration (FNA) of thyroid lesions, in correlation with final surgical pathology. This is the first study of its kind to our knowledge.
  
  
  METHODS
  We retrospectively reviewed thyroid FNA cytology between January 2005 and February 2011. Consecutive FNA specimens with corresponding follow-up surgical pathology were included. The patients were categorized as African- American (AA) and Non-African-American (NAA), which included Caucasians (C), Hispanics (H), and Others (O). The FNA results were classified using the latest edition of The Bethesda System for Reporting Thyroid Cytopathology (TBS-Thy) and the follow-up surgical pathology was used for the final categorization.
  
  
  RESULTS
  We studied 258 cases: 144 AA (56%) and 114 NAA [43 C (17%), 3 H (1%), and 68 O (28%)]. The average age for AA was 51 years (range 20 - 88) and for NAA was 53 years (range 25 - 86). There were more females than males in the AA versus the NAA group (85 vs. 75%). The incidence of thyroid lesions in the FNA specimens was similar between these two populations. The distribution of benign versus malignant diagnosis on follow-up surgical pathology was examined across TBS-Thy class.
  
  
  CONCLUSIONS
  Our data suggest that distribution of benign versus malignant lesions in the thyroid FNA of AA versus NAA, with follow-up surgical pathology, is comparable for TBS-Thy classes, non-diagnostic (I), benign (II), suspicious for malignancy (V), and malignant (VI) in AA versus NAA.
authors.affiliation: Department of Pathology, Wayne State University School of Medicine and Detroit Medical Center, Detroit, MI, USA.
authors.forename: Pamela Anne
authors.initials: PA
authors.lastname: Archuletta
authors.forename: Raja
authors.initials: R
authors.lastname: Gidwani
authors.forename: Mujtaba
authors.initials: M
authors.lastname: Husain
authors.forename: Teresa
authors.initials: T
authors.lastname: Johnson
authors.forename: Vinod
authors.initials: V
authors.lastname: Shidham
authors.forename: Opada
authors.initials: O
authors.lastname: Alzohaili
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Bandyopadhyay
authors.forename: Jining
authors.initials: J
authors.lastname: Feng
authors.forename: Dongping
authors.initials: D
authors.lastname: Shi
authors.forename: Lili
authors.initials: L
authors.lastname: Geng
authors.forename: Paul
authors.initials: P
authors.lastname: Tranchida
authors.forename: Tamar
authors.initials: T
authors.lastname: Giorgadze