In the current study, we found the ROM to be significantly higher in the AUS/FLUS category for patients younger than 55 years of age. However, the ROM presented across many studies, including our own, depends heavily upon the prevalence of thyroid cancer in the specific patient population being studied . Thus, it is of paramount importance for each institution that employs the BSRTC to guide clinical decision making to monitor its usage and to be aware of their ROM for each individual diagnostic category .