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Commentary

Free Access

The Bethesda System for Reporting Cervical Cytology: A Historical Perspective

Nayar R.a · Wilbur D.C.b

Author affiliations

aDepartment of Pathology, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, IL, and bDepartment of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

Corresponding Author

Correspondence to: Dr. Ritu Nayar

Northwestern Memorial Hospital

Cytopathology Galter 7-132B, 251 East Huron Street,

Chicago, IL 60611 (USA)

E-Mail r-nayar@northwestern.edu

Related Articles for ""

Acta Cytologica 2017;61:359-372

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Abstract

The aims of The Bethesda System (TBS) were to provide effective communication from the laboratory to the clinical provider; facilitate cytologic-histologic correlation; facilitate research into the epidemiology, biology, and pathology of cervical disease; and provide reproducible and reliable data for national and international statistical analysis comparisons. Dr. Diane Solomon and colleagues' contribution to cervical cancer screening, diagnosis, and management began with the inception and dissemination of TBS for reporting cervical cytology in 1988, as detailed in the accompanying article [Solomon et al.: Acta Cytol 1989;33:567-574]. The significance of TBS for the further development and implementation of standardized terminology in pathology, and the research/management of cervical cancer have continued to evolve over the past three decades. TBS has always been a multidisciplinary effort and acknowledgement needs to be given to several stakeholders who, over the years, have contributed to its success. It has been our privilege and honor to have carried on the legacy of this seminal work, even as molecular methods are being closely integrated into cervical cancer screening, triage, and prevention.

© 2017 S. Karger AG, Basel


References

  1. Solomon D, et al: The 1988 Bethesda System for reporting cervical/vaginal cytologic diagnoses. Developed and approved at the National Cancer Institute Workshop, Bethesda, Maryland, USA, December 12-13, 1988. Acta Cytol 1989;33:567-574.
  2. Kurman RJ, Solomon D (eds): The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses. Definitions, Criteria, and Explanatory Notes for Terminology and Specimen Adequacy. New York, Springer, 1994.
  3. Schiffman M, Adrianza ME: ASCUS-LSIL triage study. Design, methods and characteristics of trial participants. Acta Cytol 2000;44:726-742.
  4. Stoler MH, Schiffman M: Interobserver variability of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-LSIL triage study. JAMA 2001;285:1500-1505.
  5. Gage JC, Hanson VW, Abbey K, Dippery S, Gardner S, Kubota J, Schiffman M, Solomon D, Jeronimo J: Number of cervical biopsies and sensitivity of colposcopy. Obstet Gynecol 2006;108:264-272.
  6. Solomon D, Nayar R (eds): The Bethesda System for Reporting Cervical Cytology. Definitions, Criteria, and Explanatory Notes. New York, Springer, 2004.
  7. Sherman ME, Dasgupta A, Schiffman M, Nayar R, Solomon D: The Bethesda Interobserver Reproducibility Study (BIRST): a web based assessment of the Bethesda 2001 System for classifying cervical cytology. Cancer Cytopathol 2007;111:15-25.
  8. National Cancer Institute, American Society of Cytopathology: Bethesda System Website Atlas. http://nih.techriver.net/ (accessed May 9, 2017).
  9. Wright TC, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ: 2001 Consensus guidelines for the management of women with cervical cytological abnormalities. JAMA 2002;287:2120-2129.
  10. Wright TC Jr, Massad SL, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D: 2006 Consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol 2007;197:346-355.
  11. Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M, Solomon D, Wentzensen N, Lawson H: 2012 Updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 2013;17(5 suppl 1):S1-S27.
  12. Nayar R, Wilbur DC: The Pap test and Bethesda 2014. Cancer Cytopathol 2015:123:271-281.
  13. Nayar R, Wilbur DC (eds): The Bethesda System for Reporting Cervical Cytology, ed 3. Definitions, Criteria, and Explanatory Notes. New York, Springer, 2015.
  14. The 2014 Bethesda Cervical Cytology Web Atlas. https://bethesda.soc.wisc.edu/ (accessed May 10, 2017).
  15. Kurtycz DFI, Staats P, Chute D, Russell D, Pavelec D, Monaco SE, Friedlander MA, Wilbur DC, Nayar R: Bethesda Interobserver Reproducibility Study-2 (BIRST-2): Bethesda System 2014. J Am Soc Cytopathol 2017;6: 131-144.
    External Resources
  16. Ali SZ, Cibas ES (eds): The Bethesda System for Reporting Thyroid Cytopathology. Definitions, Criteria, and Explanatory Notes. New York, Springer, 2010.
  17. Layfield LJ, Pitman MB, DeMay RM, Shidham VB: Pancreaticobiliary tract cytology: journey toward “Bethesda” style guidelines from the Papanicolaou Society of Cytopathology. Cytojournal 2014;11:18.
  18. Rosenthal DL, Wojcik EM, Kurtycz DFI (eds): The Paris System for Reporting Urinary Cytology. New York, Springer, 2016.
  19. Rossi ED, Faquin WC, Baloch Z, Barkan GA, Foschini MP, Pusztaszeri M, Vielh P, Kurtycz DFI: The Milan system for reporting salivary gland cytopathology: analysis and suggestions from initial survey. Cancer Cytopathol 2017 (in press).
  20. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino RJ, Wilbur DC; LAST Project Work Groups: The lower anogenital squamous terminology standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Arch Pathol Lab Med 2012;136:1266-1297.
  21. Stoler M, Bergeron C, Colgan TJ, Ferenczy AS, Herrington CS, Kim K-R: Epithelial tumours, part of tumours of the uterine cervix; in Kurman RJ, Carcangiu ML, Herrington CS, Young RH (eds): WHO Classification of Tumours of Female Reproductive Organs, chapt 7, ed 4. Lyon, IARC, 2014, pp 172-198.

Article / Publication Details

First-Page Preview
Abstract of Commentary

Received: May 17, 2017
Accepted: May 17, 2017
Published online: July 11, 2017
Issue release date: July – October

Number of Print Pages: 14
Number of Figures: 0
Number of Tables: 0

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: https://www.karger.com/ACY

References

  1. Solomon D, et al: The 1988 Bethesda System for reporting cervical/vaginal cytologic diagnoses. Developed and approved at the National Cancer Institute Workshop, Bethesda, Maryland, USA, December 12-13, 1988. Acta Cytol 1989;33:567-574.
  2. Kurman RJ, Solomon D (eds): The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses. Definitions, Criteria, and Explanatory Notes for Terminology and Specimen Adequacy. New York, Springer, 1994.
  3. Schiffman M, Adrianza ME: ASCUS-LSIL triage study. Design, methods and characteristics of trial participants. Acta Cytol 2000;44:726-742.
  4. Stoler MH, Schiffman M: Interobserver variability of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-LSIL triage study. JAMA 2001;285:1500-1505.
  5. Gage JC, Hanson VW, Abbey K, Dippery S, Gardner S, Kubota J, Schiffman M, Solomon D, Jeronimo J: Number of cervical biopsies and sensitivity of colposcopy. Obstet Gynecol 2006;108:264-272.
  6. Solomon D, Nayar R (eds): The Bethesda System for Reporting Cervical Cytology. Definitions, Criteria, and Explanatory Notes. New York, Springer, 2004.
  7. Sherman ME, Dasgupta A, Schiffman M, Nayar R, Solomon D: The Bethesda Interobserver Reproducibility Study (BIRST): a web based assessment of the Bethesda 2001 System for classifying cervical cytology. Cancer Cytopathol 2007;111:15-25.
  8. National Cancer Institute, American Society of Cytopathology: Bethesda System Website Atlas. http://nih.techriver.net/ (accessed May 9, 2017).
  9. Wright TC, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ: 2001 Consensus guidelines for the management of women with cervical cytological abnormalities. JAMA 2002;287:2120-2129.
  10. Wright TC Jr, Massad SL, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D: 2006 Consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol 2007;197:346-355.
  11. Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M, Solomon D, Wentzensen N, Lawson H: 2012 Updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 2013;17(5 suppl 1):S1-S27.
  12. Nayar R, Wilbur DC: The Pap test and Bethesda 2014. Cancer Cytopathol 2015:123:271-281.
  13. Nayar R, Wilbur DC (eds): The Bethesda System for Reporting Cervical Cytology, ed 3. Definitions, Criteria, and Explanatory Notes. New York, Springer, 2015.
  14. The 2014 Bethesda Cervical Cytology Web Atlas. https://bethesda.soc.wisc.edu/ (accessed May 10, 2017).
  15. Kurtycz DFI, Staats P, Chute D, Russell D, Pavelec D, Monaco SE, Friedlander MA, Wilbur DC, Nayar R: Bethesda Interobserver Reproducibility Study-2 (BIRST-2): Bethesda System 2014. J Am Soc Cytopathol 2017;6: 131-144.
    External Resources
  16. Ali SZ, Cibas ES (eds): The Bethesda System for Reporting Thyroid Cytopathology. Definitions, Criteria, and Explanatory Notes. New York, Springer, 2010.
  17. Layfield LJ, Pitman MB, DeMay RM, Shidham VB: Pancreaticobiliary tract cytology: journey toward “Bethesda” style guidelines from the Papanicolaou Society of Cytopathology. Cytojournal 2014;11:18.
  18. Rosenthal DL, Wojcik EM, Kurtycz DFI (eds): The Paris System for Reporting Urinary Cytology. New York, Springer, 2016.
  19. Rossi ED, Faquin WC, Baloch Z, Barkan GA, Foschini MP, Pusztaszeri M, Vielh P, Kurtycz DFI: The Milan system for reporting salivary gland cytopathology: analysis and suggestions from initial survey. Cancer Cytopathol 2017 (in press).
  20. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino RJ, Wilbur DC; LAST Project Work Groups: The lower anogenital squamous terminology standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Arch Pathol Lab Med 2012;136:1266-1297.
  21. Stoler M, Bergeron C, Colgan TJ, Ferenczy AS, Herrington CS, Kim K-R: Epithelial tumours, part of tumours of the uterine cervix; in Kurman RJ, Carcangiu ML, Herrington CS, Young RH (eds): WHO Classification of Tumours of Female Reproductive Organs, chapt 7, ed 4. Lyon, IARC, 2014, pp 172-198.

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