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Bethesda 2001: A revised system for reporting pap test results aims to improve cervical cancer

/b> The older Bethesda System grouped all cells considered equivocal -- atypical but not clearly precancerous -- into one category known as Aatypical squamous cells of undetermined significance@ or ASCUS. Bethesda 2001 adds a new category for atypical cells at higher risk of association with precancer: Aatypical squamous cells - cannot exclude a high-grade lesion@ or "ASC-H." By highlighting such cases, the new system should help physicians detect and treat precancerous lesions more rapidly. In addition, the term "atypical squamous cells favor reactive" has been eliminated in order to focus attention on women at higher risk of having an abnormality.

  • Benign Cellular Changes identified as "negative": The previous version of Bethesda included a category of "Benign cellular changes" to communicate findings due to a variety of factors (e.g. inflammation). However, this approach caused confusion at times for clinicians who questioned whether this term indicated negative results or the need for follow-up. Now such changes are more clearly identified as "negative."

    In other changes, Bethesda 2001 recommends that laboratories report the use of computerized scanning of Pap test slides and the results of molecular testing (such as tests for the human papillomavirus).

    The 2001 Bethesda System is the product of a workshop, sponsored by NCI and numerous professional societies, which took place April 30 - May 2, 2001, in Bethesda, Md. The workshop included more than 400 participants. Even broader participation in the revision process was made possible through a dedicated Web site (http://bethesda2001.cancer.gov), where more than 1,000 individual comments were received on the draft recommendations.

    More than 90 percent of laboratories in the United States use The Bethesda System, as do laboratories in many other countries. To date, more than 20 national and internation
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    • Contact: NCI Press Office
    ncipressofficers@mail.nih.gov
    301-496-6641
    NIH/National Cancer Institute
    23-Apr-2002


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