Bethesda 2001: A revised system for reporting pap test results aims to improve cervi...( A revised system for reporting the res...),Health

A revised system for reporting the results of Pap tests, published in the April 24, 2002, issue of the Journal of the American Medical Association (JAMA)*, will change the way laboratories communicate with physicians about the 50 million cervical cancer screening tests performed each year in the United States.

Known as the 2001 Bethesda System, the reporting system conveys laboratory findings that help physicians and their patients decide what to do about the abnormalities found on Pap tests.

The 2001 Bethesda System does not itself include guidelines for managing these abnormalities. However, it serves as the basis for new management guidelines that appear in a companion article in JAMA. The guidelines were developed under the sponsorship of the American Society for Colposcopy and Cervical Pathology (ASCCP) in tandem with the 2001 Bethesda System.

Publication of the two papers is considered a milestone in efforts to improve cervical cancer screening. ATogether, Bethesda 2001 and the ASCCP guidelines should provide more uniform, evidence-based care of women with cervical abnormalities,@ said Diane Solomon, M.D., who has coordinated development of The Bethesda System at the National Cancer Institute.

Bethesda 2001 updates the earlier Bethesda System, first published in 1989 and revised in 1991. The 2001 version reflects the most current knowledge about the biology of Pap test abnormalities and addresses new screening technologies that appeared in the past decade. Key changes include:

• Sample adequacy: The Bethesda System has always required laboratories to evaluate the adequacy of cervical cell samples based on a standard set of criteria. The 2001 Bethesda System incorporates criteria that are specific to the new thin-layer, or liquid-based, cell collection method now used by many doctors.

• New term (ASC-H) to denote atypical cells at higher-risk of association with precancer:<
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