Fine-needle aspiration cytology: A survey of current utilization in relationship to hospital size, surgical pathology volume, and institution type

Fine-needle aspiration cytology has become an accepted technique for the pr eoperative diagnosis of palpable and radiographically detected lesions at a wide variety of body sites. Little information exists regarding the degree of utilization of the technique in the general medical community. The pres ent study investigated the number of fine-needle aspirations (FNAs) perform ed relationship to hospital size, surgical pathology caseload and type of h ospital. Six hospitals from each state were selected at random (total of 300), and a survey was sent which requested the following information hospital size, s urgical pathology caseload, FNA volume, most common sites aspirated, change in FNA utilization over the last 5 years, and who was performing the needl e aspirates. Usable responses were received from 133 institutions. The survey revealed t hat in 63% of institutions, FNAs were performed predominantly or exclusivel y by clinicians. An increase in number of FNAs performed was reported in 73 % of institutions, while 11% reported a net decrease in FNA volume. The bre ast was the most common organ undergoing needle aspiration, followed by the thyroid and lung. For all hospitals, irrespective of size and type, FNA vo lume represented about 2.5% of the total surgical pathology volume. For non academic tertiary-care institutions, FNA represented approximately 1.2% of the surgical pathology caseload and for academic tertiary-car institutions, FNA volume was approximately 3.6% of cases. The survey indicated that utilization of FNA continues to increase, is pred ominantly performed by clinicians, and represents a greater percentage of t issue examinations in academic tertiary-care institutions than in either co mmunity general hospitals or nonacademic tertiary-care institutions. (C) 20 00 Wiley-Liss, Inc.