Identification and evaluation of thyroid nodules.

Thyroid nodules are common, occurring in about 5% to 10% of people during their lifetimes. Primary care providers are often the first to recognize the nodules and to begin evaluation to rule out malignancy or other underlying disorder. Most nodules are benign, therefore the chance of diagnosing cancer is low but appreciable. The most cost-effective initial evaluation is the fine needle aspiration biopsy, performed and interpreted by skilled clinicians. Primary care providers are responsible for providing access to the "standard of care" in a community, which usually involves referral to an endocrinologist for evaluation of thyroid nodules. Therefore, most primary care providers are key participants in terms of thyroid nodule identification; appropriate and timely referral, and follow-up surveillance.