Caution Against Overinvestigation of Small Thyroid Nodules

To the Editor A recent study by Magister et al¹ aimed to determine whether thyroid nodule size affected fine-needle aspiration biopsy (FNAB) results and determined malignancy rates in each Bethesda class. The authors¹ found that nodules smaller than 2 cm had increased probability of malignancy irrespective of the Bethesda class and stated, “our data would suggest that smaller thyroid nodules, as opposed to larger thyroid nodules, pose a relatively increased risk of malignant disease and should be viewed with caution.” We are concerned that these results can be misleading to readers and fuel the problem of overinvestigation of thyroid nodules and overdiagnosis of thyroid cancer.