Awareness, Progress, and the Search for Answers
Thyroid Cancer Awareness Month is a chance to broaden our understanding not only of thyroid cancer, but also of the clinical considerations and decision-making pathways that can arise when a thyroid nodule is discovered. The path forward may involve several tests and conversations centered on a question that can weigh heavily on patients and their families: Could this be cancer?
Up to 30% of thyroid fine-needle aspiration (FNA) biopsies do not clearly show whether a nodule is cancerous or benign.1 The result is instead classified as an indeterminate thyroid nodule, leaving patients uncertain about what the finding means and what should happen next. Historically, many patients with an indeterminate result proceeded to diagnostic surgery, only to learn afterward that their nodules were benign. In fact, up to 80% of these surgeries ultimately proved unnecessary because the nodules were not cancerous.1
For patients, this uncertainty can make already difficult questions feel even more pressing: Should I have surgery? Is it possible that the nodule is benign? Do I have enough information to make this decision?
Since becoming Veracyte’s first commercial test in 2011, the Afirma thyroid nodule molecular test has helped address this uncertainty by providing genomic insights for patients with indeterminate thyroid nodules. Today, the Afirma Genomic Sequencing Classifier (GSC) is the market leader in thyroid molecular analysis,2 and more than 400,000 patients have benefited from Afirma testing.3 That impact is an important part of Veracyte’s broader story as the company approaches one of the most meaningful milestones in its history: serving its one millionth patient.
During Thyroid Cancer Awareness Month, these numbers are a reminder that progress is built one patient, one conversation and one care decision at a time.
Bringing Greater Clarity to What Comes Next
For a patient with an indeterminate biopsy result, deciding what to do next can feel like standing at a crossroads. Surgery may be the appropriate choice, but what if the nodule is benign? Is surgery necessary, or is continued observation an option? These decisions can carry medical, emotional and quality-of-life considerations for patients and their families.
The Afirma test is an advanced diagnostic test designed to help reduce this uncertainty and help avoid unnecessary thyroid surgery. By analyzing genomic content from a patient’s thyroid nodule, the Afirma test can reveal important information that the clinician can consider alongside biopsy findings and other clinical factors when developing an individualized care plan.
When an Afirma test result indicates that an indeterminate nodule is likely benign, the patient may be able to avoid diagnostic surgery and continue with monitoring instead. When a result is suspicious, the Afirma test can provide additional genomic information to help the physician guide informed thyroid nodule care.
Across the hundreds of thousands of patients tested to date, Veracyte estimates that the Afirma test has helped spare over 66% of them an unnecessary surgery.4 But its impact is not measured by surgeries avoided alone.
Whether the next step is monitoring or surgery, the goal is the same: to help patients receive care that is most appropriate for their thyroid nodule. Because these decisions carry real consequences, that clarity must be grounded in evidence clinicians can trust.
Evidence That Holds Up in the Real World
When molecular information may help guide a decision about monitoring, surgery or treatment, the quality of the evidence matters. The Afirma test’s evidence base includes rigorous clinical validation and years of independent real-world research showing how the test performs across patients and practice settings.
A 2022 meta-analysis published in The Journal of Clinical Endocrinology & Metabolism (JCEM) brought together 13 independent studies encompassing nearly 2,000 patients with indeterminate thyroid nodules. The researchers found that Afirma GSC achieved a 99% negative predictive value, meaning that when the test identified a nodule as benign, it did so with a high degree of accuracy.5 The analysis also found that the Afirma test’s performance in real-world clinical practice was consistent with, and on some measures exceeded, results from its original clinical validation study.4
More recently, an independent 2024 study by Ahmadi et al. examined outcomes for more than 800 indeterminate thyroid nodules across three academic medical centers, with a median follow-up of 23 months. Afirma GSC demonstrated negative predictive values of 99% for Bethesda III nodules and 98% for Bethesda IV nodules, and most nodules with an Afirma GSC-benign result remained stable during surveillance.6 These findings support the researchers’ conclusion that Afirma GSC-benign nodules may be observed similarly to nodules with benign cytology,5 reinforcing the test’s value in helping physicians identify patients who may be able to avoid unnecessary surgery.
For physicians, this growing body of research provides greater confidence in using the Afirma test in a broad range of patients and clinical settings. For patients, it can support a more informed conversation about the appropriate next step, whether that means continued monitoring, surgery or other treatment. That is what evidence ultimately represents: not simply more studies or statistics, but reliable information that helps patients and physicians move forward together.
The clinical evidence behind the Afirma test supports patient care decisions today. At the same time, the genomic information and experience behind the test are creating opportunities for researchers to investigate new questions about thyroid nodules and thyroid cancer.
Advancing Thyroid Research Through Collaboration
Scientific progress often begins by asking what more can be learned from the information already available. Through collaboration with independent investigators, Veracyte is helping researchers explore thyroid nodules and thyroid cancer at the molecular level through the Afirma Genomic Resource for Intelligent Discovery (GRID).
Afirma GRID is a proprietary, research-use-only database. It provides researchers with access to more than 400,000 whole-transcriptome profiles and up to 46 locked gene-expression data points, creating an important resource for studying thyroid nodule and thyroid cancer biology. n 2025, GRID data supported 25 studies on new genomic signatures and biomarkers of interest.7
A recent example of GRID’s research potential came from an independent, single-institution study led by researchers at NYU Langone Health and presented at the 2026 American Association of Endocrine Surgeons (AAES) Annual Meeting. The investigators used GRID gene-expression signatures to develop an exploratory model for identifying Bethesda III–VI nodules that may be higher risk thyroid cancers.8 The work earned the meeting’s Geoffrey Thompson Award for Best Poster, an important recognition of the study’s contribution to thyroid research.
These preliminary findings point to how GRID can help investigators explore new approaches to preoperative thyroid nodule risk stratification.7 The researchers noted that their model and proposed cutpoints require validation in multi-institutional or independent datasets. GRID itself is for research use only and is not intended to guide patient management.7
This distinction is important. Afirma GSC’s validated clinical performance supports care decisions today, while GRID offers researchers a resource for exploring questions that may deepen scientific understanding over time. Together, they reflect Veracyte’s commitment to building on what is already known while continuing to investigate what more may be possible for patients with thyroid nodules and thyroid cancer.
What Progress Means for Patients
Thyroid Cancer Awareness Month is a reminder that awareness should lead to greater understanding and more informed conversations about care. For patients with an indeterminate thyroid nodule, progress means having the information needed to work with their physician and determine an appropriate next step – whether that is monitoring, surgery or treatment.
Through the Afirma GSC test’s established clinical evidence and continued investment in thyroid research, Veracyte remains focused on standing alongside physicians and their patients as they make these consequential decisions with greater confidence.