Abstract:
Introduction
Thyroid diseases are common in our setting
leading to significant morbidity [1]. According to
National Cancer incidence data thyroid
malignancies were the 3rd commonest malignancy
in women in 2010. In men, thyroid malignancies
were placed 3rd among the age group 15-34 years
and 5th among 35-49 years [2]. Thyroid fine needle
aspiration cytology test (FNAC) is a front line
investigation to assess the possibility of a
neoplasm in patients presenting with thyroid
nodules. The original ‘Thy’ classification of the
British thyroid association of the Royal College of
pathologists of United Kingdom (RCP UK) formed
the basis for thyroid FNAC reporting in Sri Lanka,
since 2007[3]. In May 2014, the College of
Pathologists of Sri Lanka initiated a dialog with the
clinical stakeholders regarding issues related to
the ‘Thy’ based FNAC reporting. Following
discussions at a workshop attended by
representatives from the Colleges of Pathologists,
Radiologists, Surgeons and Endocrinologists, the
Bethesda system (TBSRTC) was adopted for
thyroid FNAC reporting in our setting [4].
Reporting the risk of subsequent malignancy
(ROM) for each category was however not
adopted till the availability of local data. The
hand book titled ‘Thyroid Cytology Reporting.
National Guidelines for Sri Lanka’ (NGSL) based on
TBSRTC was published by the Ministry of Health in
2016 [5]. Currently NGSL forms the frame work
for thyroid FNAC reporting in our setting. Some
concerns have since been expressed regarding
TBSRTC based NGSL guidelines.
