Evaluation of thyroid nodules in the brazilian public health care system, supplementary health system, and private health system in the northeastern region of the state of São Paulo
Arch. endocrinol. metab. (Online)
; 64(6): 779-786, Nov.-Dec. 2020. tab, graf
Article
in English
| LILACS
| ID: biblio-1142209
Responsible library:
BR1.1
ABSTRACT
ABSTRACT Objective:
To obtain data about the evaluation of thyroid nodules (TNs) in the northeastern of the State of São Paulo, compared by health care type, and measure the performance of cytology as a screening test for thyroid cancer (TC). Subjects andmethods:
We collected data of 597 patients treated in the Brazilian public health care system (SUS), supplementary health (SH) and in private health system (PHS) in 2014. A total of 803 TNs were aspirated, and 125 patients underwent surgery.Results:
The distribution of all cytologic results according to the Bethesda system was I, 135 (16.8%); II, 475 (59.2%); III, 107 (13.3%); IV, 32 (4.0%); V, 20 (2.5%); VI, 34 (4.2%). The time between cytologic analysis and surgery was longer in the SUS than in the SH for TNs in general (p < 0.001) and for TNs with Bethesda V and VI cytology (p = 0.01). The sizes of the TNs and resected malignant TNs was larger in the SUS than in the SH (p = 0.001 and p = 0.02, respectively). The number of PHS surgeries was too small and was not compared. The prevalence of TC was 9.2% and 23.6% of them were treated in the SUS. Cytology showed a 93.6% sensitivity, 95.8% specificity, and 94.7% accuracy when Bethesda III and IV were excluded.Conclusion:
Cytology was a good screening test for TC categories Bethesda II, V, and VI. The differences between the SUS and SH indicate a need for improved access to consultations and specialized tests in the SUS.
Full text:
Available
Collection:
International databases
Database:
LILACS
Type of study:
Evaluation study
/
Risk factors
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Arch. endocrinol. metab. (Online)
Journal subject:
Endocrinology
/
Metabolism
Year:
2020
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Soares Patologia e Citopatologia/BR
/
Universidade de São Paulo/BR