Costings For Thyroid FNA Cytology

This website, formerly the site of The British Society for Clinical Cytology (BSCC), is now under new ownership, with effect from April 2013. I have placed on this site a copy of the abstract and the title page from a recent article that we published in The Journal of Clinical Pathology on NHS costings for thyroid FNA cytology, in the hope that it will generate interest and discussion in the British cytology community about how to improve rates of cellular adequacy and quality in thyroid FNA.

A simple spreadsheet economic model for delivery of thyroid fine needle aspiration (FNA) cytology is described. Using the UK Royal College of Pathologists’ Classification for thyroid fine needle aspiration which is based on The Bethesda System for Reporting Thyroid Cytology (TBSRTC) we show an estimated 27.8% cost treatment reduction per patient if low rates of non-diagnostic for cytological diagnosis (Thy 1) and neoplasm possible atypia/non-diagnostic (Thy 3a) are achieved, which require rapid on site FNA adequacy assessment of aspiration samples. If we assume that the number of thyroid FNA’s performed in the UK annually is around 500 per million, and the UK population is 62 million, this could save the UK National Health Service significant sums, as the cost per patient treated in this model varies from £781 for a scenario with ultrasound guided FNA and in clinic cell adequacy assessment to £998 where aspirates are taken in conventional fashion without any in clinic adequacy assessment. This model makes a strong economic case for the introduction of rapid on site assessment of thyroid FNA across cancer networks, to improve the diagnostic efficacy of thyroid FNA

Click on this password protected link to download the excel spreadsheet file with the economic model copyright Kandaswamy & Poller, all rights reserved, January 2013