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:
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 international societies have endorsed Bethesda 2001.
Note: Graphics, photos, audio clips, and an interview with Dr. Solomon will be available after the embargo lifts at http://newscenter.cancer.gov/behindnews . Or call the NCI Press Office at 301-496-6641.
The ASCCP management guidelines will be presented at a press conference sponsored by the Society. Call ASCCP/Wallapix Media Relations at 914-238-7197 for more information or go to the ASCCP Web site at http://www.asccp.org .
JAMA