SAME-DAY FINE NEEDLE ASPIRATION CYTOLOGY DIAGNOSIS FOR THYROID NODULES ACHIEVES RAPID ANXIETY DECREASE AND HIGH DIAGNOSTIC ACCURACY

BACKGROUND: The time between the moment of referral for the diagnostic work-up for thyroid nodules and the outcome can be worrisome for patients. In general, patients experience high levels of anxiety during the evaluation of a lesion suspicious for cancer. Therefore, the implementation of same-day Fine Needle Aspiration Cytology (FNAC) diagnosis is becoming standard-of-care for many solid tumours. Our aim was to assess feasibility of same-day FNAC diagnosis for thyroid nodules and to assess patient anxiety during the diagnostic process.

METHODS: For feasibility of same-day FNAC diagnosis we assessed the proportion of patients receiving a diagnosis at the end of the visit. Accuracy was measured by comparing histology with the FNAC result. Patients' anxiety was measured by the STAI on six moments during the diagnostic work-up..

RESULTS: Of the 131 included patients, 112 (86%) were female and the mean age was 53 years. All patients, except those with a nondiagnostic FNAC result (n=26; 20%), had a diagnosis at the end of the day. There was only 1 discordant result. Anxiety levels at the beginning of the day were high throughout the group, 43.1 (SD 2.0) and decreased significantly more in patients with a benign FNAC result (30.2) compared to patients with a malignant or indeterminate result (39.6).

CONCLUSION: Distress of patients with a thyroid nodule undergoing same-day FNAC diagnostics was high. Same-day FNAC diagnosis is feasible and accurate for the evaluation of thyroid nodules. Therefore, same-day FNAC diagnosis seems a safe, more patient-friendly approach to diagnose thyroid nodules.