Table 1. Studies reviewed for AUS/FLUS incidence, RR, ROM and OROM.
| Study | Region | Study period | No. of FNAs | AUS/FLUS | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. of total cases | I | R | M | RR | ROM | OROM | ||||
| Asian | ||||||||||
| Gan 2017, (16) | Singapore | 2008–2014 | 4,815 | 309 | 0.064 | 137 | 37 | 0.443 | 0.270 | 0.120 |
| Keelawat 2017, (17) | Thailand | 2010–2017 | 7,447 | 159 | 0.021 | 117 | 42 | 0.736 | 0.359 | 0.264 |
| Thewjitcharoen 2019, (18) | Thailand | 2010–2017 | 2,735 | 128 | 0.047 | 30 | 3 | 0.234 | 0.100 | 0.023 |
| Mao 2017, (19) | Mainland China | 2014–2015 | 3,090 | 442 | 0.143 | 121 | 43 | 0.274 | 0.355 | 0.097 |
| Zheng 2018, (20) | Mainland China | 2014–2016 | 7,355 | 736 | 0.100 | NA | NA | NA | NA | NA |
| Ke 2019, (21) | Mainland China | 2011–2016 | 13,351 | 1,764 | 0.132 | 157 | 83 | 0.089 | 0.529 | 0.047 |
| Jan 2019, (22) | Taiwan | 2012–2016 | 29,937 | 770 | 0.026 | 367 | 204 | 0.477 | 0.556 | 0.265 |
| Satoh 2017, (23) | Japan | 2015–2016 | 1,600 | 171 | 0.107 | 47 | 7 | 0.275 | 0.149 | 0.041 |
| Kim 2011, (24) | Korea | 2007–2009 | 865 | 141 | 0.163 | 33 | 24 | 0.234 | 0.727 | 0.170 |
| Chung 2011, (25) | Korea | 2005–2010 | 3,962 | 515 | 0.130 | 166 | 108 | 0.322 | 0.651 | 0.210 |
| Hyeon 2014, (26) | Korea | 2011–2012 | 6,402 | 551 | 0.086 | 231 | 157 | 0.419 | 0.680 | 0.285 |
| Park 2014, (7) | Korea | 2010–2011 | 3,589 | 331 | 0.092 | 95 | 77 | 0.287 | 0.811 | 0.233 |
| Yoo 2015, (27) | Korea | 2010–2012 | 11,988 | 772 | 0.064 | 287 | 234 | 0.372 | 0.815 | 0.303 |
| Jung 2015, (28) | Korea | 2011–2014 | 18,091 | 163 | 0.009 | 71 | 47 | 0.436 | 0.662 | 0.288 |
| Koh 2016, (29) | Korea | 2012–2013 | 1,754 | 123 | 0.070 | 32 | 28 | 0.260 | 0.875 | 0.228 |
| Kim SJ 2017, (30) | Korea | 2012 | 5,321 | 346 | 0.065 | NA | NA | NA | NA | NA |
| Kim SD 2017, (31) | Korea | 2010–2014 | 8,458 | 660 | 0.078 | NA | NA | NA | NA | NA |
| Kim M 2017, (32) | Korea | 2011 | 42,132 | 4,100 | 0.097 | 828 | 569 | 0.202 | 0.687 | 0.139 |
| Hong 2018, (33) | Korea | 2011–2014 | 6,365 | 717 | 0.113 | 96 | 70 | 0.134 | 0.729 | 0.098 |
| Mondal 2013, (34) | India | 2009–2012 | 1,020 | 10 | 0.010 | NA | NA | NA | NA | NA |
| Mehra 2015, (35) | India | 2010–2012 | 225 | 11 | 0.049 | NA | NA | NA | NA | NA |
| Garg 2015, (36) | India | 2012–2014 | 100 | 4 | 0.040 | NA | NA | NA | NA | NA |
| Arul 2015, (37) | India | 2012–2015 | 603 | 60 | 0.100 | 41 | 10 | 0.683 | 0.244 | 0.167 |
| Mahajan 2017, (38) | India | 2010–2015 | 4,562 | 116 | 0.025 | NA | NA | NA | NA | NA |
| Kumari 2019, (39) | India | NA | 1,050 | 10 | 0.010 | NA | NA | NA | NA | NA |
| Naz 2014, (40) | Bangladesh | NA | 528 | 67 | 0.127 | NA | NA | NA | NA | NA |
| Ozluk 2011, (41) | Turkey | 2004–2007 | 581 | 25 | 0.043 | NA | NA | NA | NA | NA |
| Ustün 2012, (42) | Turkey | 2007–2011 | 14,629 | 3,903 | 0.267 | 1,756 | 228 | 0.450 | 0.130 | 0.058 |
| Firat 2012, (43) | Turkey | 2010–2012 | 764 | 75 | 0.098 | NA | NA | NA | NA | NA |
| Dincer 2013, (15) | Turkey | 2009–2010 | 7,658 | 368 | 0.048 | 88 | 23 | 0.239 | 0.261 | 0.063 |
| Tepeoðlu 2014, (44) | Turkey | 2009–2011 | 1,021 | 100 | 0.098 | 79 | 10 | 0.790 | 0.127 | 0.100 |
| Onder 2014, (13) | Turkey | 2009–2012 | 6,310 | 421 | 0.067 | 103 | 18 | 0.245 | 0.175 | 0.043 |
| Muratli 2014, (45) | Turkey | 2008–2013 | 1,607 | 140 | 0.087 | NA | NA | NA | NA | NA |
| Gocun 2014, (46) | Turkey | 2010–2013 | 4,916 | 347 | 0.071 | 82 | 22 | 0.236 | 0.268 | 0.063 |
| Kuru 2016, (47) | Turkey | 2011–2015 | 5,157 | 607 | 0.118 | 179 | 41 | 0.295 | 0.229 | 0.068 |
| Selek 2016, (48) | Turkey | 2009–2014 | 10,769 | 560 | 0.052 | 112 | 46 | 0.200 | 0.411 | 0.082 |
| Turkyilmaz 2017, (49) | Turkey | 2011–2015 | 9,938 | 1,007 | 0.101 | 305 | 111 | 0.303 | 0.364 | 0.110 |
| Öcal 2019, (50) | Turkey | 2009–2015 | 233 | 106 | 0.455 | NA | NA | NA | NA | NA |
| Mufti 2012, (51) | KSA | 2005–2010 | 250 | 2 | 0.008 | NA | NA | NA | NA | NA |
| Al-Abbadi 2013, (52) | KSA | 2010–2011 | 205 | 15 | 0.073 | NA | NA | NA | NA | NA |
| Alabdulqader 2015, (53) | KSA | 2012–2013 | 251 | 25 | 0.100 | NA | NA | NA | NA | NA |
| Al Dawish 2017, (54) | KSA | 2012–2014 | 1,433 | 131 | 0.091 | 42 | 6 | 0.321 | 0.143 | 0.046 |
| Hirsch 2015, (55) | Israel | 2011–2012 | 3,927 | 457 | 0.116 | 66 | 30 | 0.144 | 0.455 | 0.066 |
| Ronen 2019, (56) | Israel | 2013–2017 | 287 | 38 | 0.132 | NA | NA | NA | NA | NA |
| Sinna 2012, (57) | Egypt | 2005–2010 | 296 | 40 | 0.135 | NA | NA | NA | NA | NA |
| Al-Abbadi 2017, (58) | UAE | 2010–2014 | 2,592 | 115 | 0.044 | 33 | 11 | 0.287 | 0.333 | 0.096 |
| Non-Asian | ||||||||||
| Jo 2010, (59) | USA | 1992–2009 | 3,080 | 104 | 0.034 | 53 | 9 | 0.510 | 0.170 | 0.087 |
| Rabaglia 2010, (60) | USA | 2008–2009 | 765 | 91 | 0.119 | 32 | 4 | 0.352 | 0.125 | 0.044 |
| Luu 2011, (8) | USA | 2004–2009 | 7,072 | 222 | 0.031 | 127 | 33 | 0.572 | 0.260 | 0.149 |
| Olson 2011, (61) | USA | 2009–2011 | 3,956 | 388 | 0.098 | 133 | 43 | 0.343 | 0.323 | 0.111 |
| VanderLaan 2011, (6) | USA | 2005–2009 | 4,691 | 512 | 0.109 | 199 | 96 | 0.389 | 0.482 | 0.188 |
| Bongiovanni 2012, (62) | USA | 2007–2009 | 3,724 | 248 | 0.067 | 132 | 19 | 0.532 | 0.144 | 0.077 |
| Chen 2012, (63) | USA | 2006–2011 | 393 | 61 | 0.155 | 32 | 6 | 0.525 | 0.188 | 0.098 |
| Horne 2012, (64) | USA | 2008–2009 | 6,205 | 171 | 0.028 | 106 | 29 | 0.620 | 0.274 | 0.170 |
| Harvey 2013, (65) | USA | 2009–2011 | 3,432 | 72 | 0.021 | 31 | 6 | 0.431 | 0.194 | 0.083 |
| Nagarkatti 2013, (66) | USA | 2005–2007 | 5,391 | 254 | 0.047 | 151 | 24 | 0.594 | 0.159 | 0.094 |
| Olson 2013, (67) | USA | 2009–2012 | 3,885 | 575 | 0.148 | 106 | 32 | 0.184 | 0.302 | 0.056 |
| Theoharis 2013, (68) | USA | 2007–2008 | 3,207 | 95 | 0.030 | NA | NA | NA | NA | NA |
| Broome 2014, (69) | USA | 2009–2012 | 3,200 | 306 | 0.096 | 170 | 28 | 0.556 | 0.165 | 0.092 |
| Ho 2014, (70) | USA | 2008–2011 | 8,862 | 709 | 0.080 | 381 | 144 | 0.537 | 0.378 | 0.203 |
| Lee 2014, (71) | USA | 2011–2012 | NA | 122 | NA | 60 | 16 | 0.492 | 0.267 | 0.131 |
| Mathur 2014, (72) | USA | 2009–2013 | 4,827 | 806 | 0.167 | 255 | 99 | 0.316 | 0.388 | 0.123 |
| McElroy 2014, (73) | USA | 2006 | 97 | 7 | 0.072 | NA | NA | NA | NA | NA |
| Sullivan 2014, (74) | USA | 2003–2012 | 5,665 | 332 | 0.059 | 168 | 56 | 0.506 | 0.333 | 0.169 |
| Walts 2014, (75) | USA | 2008–2012 | 5,079 | 457 | 0.090 | 181 | 60 | 0.396 | 0.331 | 0.131 |
| Wu 2014, (12) | USA | 2002–2008 | 3,346 | 670 | 0.200 | 138 | 25 | 0.206 | 0.181 | 0.037 |
| Deniwar 2015, (76) | USA | 2010–2014 | 723 | 94 | 0.130 | 65 | 22 | 0.691 | 0.338 | 0.234 |
| Kantola 2016, (77) | USA | 2011–2013 | 2,156 | 159 | 0.074 | 67 | 12 | 0.421 | 0.179 | 0.075 |
| Brandler 2016, (78) | USA | 2012–2014 | 11,481 | 976 | 0.085 | 321 | 112 | 0.329 | 0.349 | 0.115 |
| Krauss 2016, (79) | USA | 1999–2013 | 5,574 | 238 | 0.043 | 55 | 14 | 0.231 | 0.255 | 0.059 |
| Shrestha 2016, (80) | USA | 2006–2012 | NA | 221 | NA | 101 | 29 | 0.457 | 0.287 | 0.131 |
| Valderrabano 2016, (81) | USA | 2008–2014 | 2,829 | 340 | 0.120 | 188 | 53 | 0.553 | 0.282 | 0.156 |
| Guo 2017, (82) | USA | 2011–2015 | 236 | 8 | 0.034 | NA | NA | NA | NA | NA |
| Deaver 2018, (83) | USA | 2011–2015 | 2,019 | 231 | 0.114 | 94 | 23 | 0.407 | 0.245 | 0.100 |
| Seagrove-Guffey 2018, (84) | USA | 2015 | 893 | 43 | 0.048 | NA | NA | NA | NA | NA |
| Bresler 2019, (85) | USA | 2012–2015 | 2,258 | 213 | 0.094 | 99 | 37 | 0.465 | 0.374 | 0.174 |
| Williams 2013, (86) | Canada | 2006–2010 | 1,491 | 281 | 0.188 | NA | NA | NA | NA | NA |
| Bernstein 2016, (87) | Canada | 2010–2013 | 1,944 | 233 | 0.120 | 187 | 86 | 0.803 | 0.460 | 0.369 |
| Erivwo 2018, (88) | Canada | 2010–2013 | 3,285 | 181 | 0.055 | NA | NA | NA | NA | NA |
| Rosario 2014, (9) | Brazil | 2009–2013 | 1,742 | 150 | 0.086 | 135 | 34 | 0.900 | 0.252 | 0.227 |
| Rosario 2017, (89) | Brazil | 2015 | 708 | 98 | 0.138 | NA | NA | NA | NA | NA |
| Reuters 2018, (90) | Brazil | 2012–2013 | 980 | 70 | 0.071 | NA | NA | NA | NA | NA |
| Mosca 2018, (11) | Brazil | 2009–2013 | 1,093 | 384 | 0.351 | NA | NA | NA | NA | NA |
| Firat 2012, (43) | France | 2009–2011 | 2,277 | 210 | 0.092 | 35 | 6 | 0.167 | 0.171 | 0.029 |
| Ratour 2013, (91) | France | 2010–2011 | 2,210 | 337 | 0.152 | 39 | 9 | 0.116 | 0.231 | 0.027 |
| Stanek-Widera 2016, (92) | Poland | 2010–2016 | 16,656 | 395 | 0.024 | 35 | 8 | 0.089 | 0.229 | 0.020 |
| Estrada Muñoz 2017, (93) | Spain | 2010–2014 | 3,032 | 151 | 0.050 | 55 | 8 | 0.364 | 0.145 | 0.053 |
| Paajanen 2018, (94) | Finland | 2011–2012 | 415 | 32 | 0.077 | NA | NA | NA | NA | NA |
| Mileva 2018, (95) | Macedonia | 2012–2016 | 4,738 | 281 | 0.059 | 90 | 34 | 0.320 | 0.378 | 0.121 |
| Sarkis 2014, (96) | Australia | 2010–2013 | 2,076 | 97 | 0.047 | 54 | 5 | 0.557 | 0.093 | 0.052 |
| Fatman 2015, (97) | S. Africa | 2008–2011 | 1,767 | 141 | 0.080 | 44 | 17 | 0.312 | 0.386 | 0.121 |
AUS/FLUS, atypia of undetermined significance/follicular lesion of undetermined significance; FNA, fine needle aspiration; I, incidence; R, number of resected cases; M, number of malignant cases; RR, resection rate; ROM, risk of malignancy; OROM, overall risk of malignancy; NA, not available.