Pap test results. Responding to Bethesda system reports

To review the adequacy and diagnostic categories of the Bethesda system for reporting Pap test results (cervicovaginal cytology) and summarize management options. The latest research evidence and guidelines from both international and Canadian sources are reviewed. With a few exceptions, good eviden...

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Bibliographic Details
Published in:Canadian family physician 2001-07, Vol.47 (7), p.1425-1430
Main Author: Colgan, T J
Format: Article
Language:English
Subjects:
Cervical cancer
Cervical Intraepithelial Neoplasia - classification
Cervical Intraepithelial Neoplasia - pathology
Cervical Intraepithelial Neoplasia - therapy
Colposcopy
Female
Guidelines as Topic
Humans
Papanicolaou Test
Terminology as Topic
Testing
Uterine Cervical Dysplasia - classification
Uterine Cervical Dysplasia - pathology
Uterine Cervical Dysplasia - therapy
Uterine Cervical Neoplasms - classification
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - therapy
Vaginal Smears - classification
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Summary:To review the adequacy and diagnostic categories of the Bethesda system for reporting Pap test results (cervicovaginal cytology) and summarize management options. The latest research evidence and guidelines from both international and Canadian sources are reviewed. With a few exceptions, good evidence supports particular management approaches for each adequacy statement and diagnostic category. Women with unsatisfactory Pap smears should be re-examined and retested. Women with satisfactory smears and a diagnosis of "within normal limits" (WNL) or "benign cellular changes" (BCC) should be retested only at recommended screening intervals. Women with "satisfactory but limited by..." results and a diagnosis of WNL or BCC should have individualized follow up. Women with diagnoses of high-grade squamous intraepithelial lesions, atypical glandular cells of uncertain significance, or malignancy should have further investigation (colposcopy). Optimal management of asymptomatic women with normal cervices and reports of atypical squamous cells of uncertain significance or low-grade squamous intraepithelial lesions is still controversial. Management of women following Pap tests is determined by both the adequacy of the test and diagnoses based on the results.
ISSN:0008-350X
1715-5258