In May 2016, The American Association of Clinical Endocrinologists (AACE), the American College of Endocrinology (ACE), and the Associazione Medici Endocrinologi (AME) issued the latest update of their Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules1.
One of the goals of this update was to stratify the risk represented by different ultrasound images of thyroid nodules. Older guidelines did not have the same emphasis on ultrasound patterns, which underwriters are seeing more frequently in attending physician statements2, 3, 4.
The update includes fine needle aspiration (FNA) recommendations as well as five histologic classifications and comprehensive treatment recommendations. The latter two will not be addressed in this brief report. The new update also addresses both the American and British Thyroid Associations ultrasound thyroid nodule classification schemes.
Prevalence of Thyroid NodulesLarge nodules exist in 5% to 8% of the healthy adult population6, 8 whereas
small nodules (<10 mm) exist in 50% to 60%1, 5. Only about 2.5% of all
thyroid nodules are malignant 6,7.