Article Citation:

Manon Auger, Ritu Nayar, Walid E. Khalbuss, Güliz A. Barkan, Cynthia C. Benedict, Rosemary Tambouret, Mary R. Schwartz, Lydia P. Howell, Rhona J. Souers, David A. Hartley, Nicole Thomas, and Ann T. Moriarty (2013) Implementation of the Bethesda System for Reporting Thyroid Cytopathology: Observations From the 2011 Thyroid Supplemental Questionnaire of the College of American Pathologists. Archives of Pathology & Laboratory Medicine: November 2013, Vol. 137, No. 11, pp. 1555-1559.

CAP LABORATORY IMPROVEMENT PROGRAMS

Implementation of the Bethesda System for Reporting Thyroid Cytopathology: Observations From the 2011 Thyroid Supplemental Questionnaire of the College of American Pathologists

Manon Auger , MD; Ritu Nayar , MD; Walid E. Khalbuss , MD, PhD; Güliz A. Barkan , MD; Cynthia C. Benedict , MD; RosemaryTambouret , MD; Mary R. Schwartz , MD; Lydia P. Howell , MD; Rhona J. Souers , MS; David A. Hartley , CT; Nicole Thomas , CT;Ann T. Moriarty , MD

From the Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada (Dr Auger);

the Department of Pathology, Northwestern University and Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar);

the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Khalbuss);

the Department of Pathology, Loyola University Medical Center, Maywood, Illinois (Dr Barkan);

DCL Pathology, LLC, Indianapolis, Indiana (Dr Benedict);

the Department of Pathology, Harvard University and Massachusetts General Hospital, Boston (Dr Tambouret);

the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Schwartz);

the Department of Pathology, University of California and University of California Davis School of Medicine, Sacramento (Dr Howell);

Staff Biostatistics (Ms Souers); staff, College of American Pathologists, Northfield, Illinois (Ms Thomas and Mr Hartley); Esoteric Testing, AmeriPath Indiana, Indianapolis, Indiana (Dr Moriarty).

Context.—Although information about the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been widely disseminated since its inception in 2007, the extent of its implementation and impact on daily practice has not been formally evaluated.

Objectives.—To assess the extent of uptake of TBSRTC across pathology laboratories and to evaluate its impact on daily practice by collating participant responses to the 2011 supplemental thyroid questionnaire of the College of American Pathologists.

Design.—A questionnaire was designed to gather information about various aspects of TBSRTC and mailed in June 2011 to 2063 laboratories participating in the College of American Pathologists cytopathology interlaboratory comparison program. The participating laboratories' answers were collated and summarized.

Results.—Seven hundred and seventy-seven laboratories (37.6%) returned the survey. Although 60.9% (n = 451) and 17.1% (n = 127) of laboratories reported using TBSRTC or planning to use it in the near future, respectively, 22% (n = 163) had no plans to implement TBSRTC. Of the latter, 32% (n = 70) stated that they were unaware of this classification system. The majority (78.3%, n = 343) of the laboratories used TBSRTC as published in the Thyroid Bethesda System atlas, whereas 21.7% (n = 95) used it with minor modifications. Most reported that the use of TBSRTC had caused either no change (n = 67, 15.2%) or only minor changes (n = 353, 80.2%) in the terminology and diagnostic criteria previously used in their laboratories.

Conclusions.—According to the collected data, TBSRTC is generally well implemented in pathology laboratories. However, because approximately a third of those not using this terminology are not aware of it, additional educational efforts regarding TBSRTC are warranted.