PSAT371 Thyroid Ultrasound, Biopsy and Cancer in a US Veteran Population

BACKGROUND: Thyroid cancer is a common malignancy and has an increasing incidence. The most common demographic is young adult women with papillary thyroid cancer, which constitutes about 75% of the disease. The decision to perform a fine needle aspiration biopsy of a thyroid nodule is based on the ultrasound appearance of the nodule. Both the American Thyroid Association and the American College of Radiology have systems by which to grade these nodules such that the risk of malignancy is predicted and biopsy is recommended. METHODS: We reviewed the medical records of all patient undergoing evaluation of a thyroid nodule at the Oklahoma City US Department of Veterans Affairs Medical Center. We recorded results of the biopsy as well as ultrasound findings and surgical pathology. RESULTS: Among 162 subjects undergoing evaluation of a thyroid nodule, 81% were men and average ago was >60 years. Only 7 of the 162 had a malignancy diagnosed. Neither age, sex, nor nodule size was associated with malignancy. All with malignancy had a TiRADS score or either 4 or 5 on ultrasonic study of the thyroid, but only a minority of TiRADS 4 (3.6%) or TiRADS 5 (5.5%) had thyroid cancer. Punctate calcium was found in 6 of the 7 with thyroid cancer and was the only finding statistically associated with malignancy. No patient with a Bethesda Classification of III or IV had malignancy CONCLUSION: The presently available estimates of cancer using thyroid ultrasound are based on a general population are not applicable to this older, predominantly male population. Determination of the need for biopsy and surgery for thyroid nodules should take age and sex into account. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.