A One-Year Cross-Sectional Study on the Impact of the Thyroid Imaging Reporting and Data System (TIRADS) on Fine-Needle Aspiration Cytology (FNAC) Decision-Making in a Secondary Care Hospital

Patient reluctance toward FNAC due to concerns over discomfort and complications remains a barrier. FNAC is generally not indicated for TIRADS categories 1 and 2. In our study, FNAC appeared unwarranted for TIRADS category 3, as none of these patients underwent surgery despite constituting 60% of the cohort, aligning with literature that reports a malignancy risk of under 5% in this category. Such nodules may be better managed through periodic surveillance and individualized risk stratification based on factors such as patient age and nodule size. In contrast, FNAC was justified and appropriately applied in TIRADS 4 and 5 categories, which carry a higher risk of malignancy. Although nodule size was not analyzed in this study, the results are consistent with previously established data.