The Pap test and Bethesda 2014
Open accessAbstract
The history of “The Bethesda System” for reporting cervical cytology goes back almost 3 decades. This terminology and the process that created it have had a profound impact on the practice of cervical cytology for laboratorians and clinicians alike. Herein, we summarize the process and rationale by which updates were made to the terminology in 2014 and outline the contents of the new, third edition of the Bethesda atlas and corresponding website.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The Bethesda System for Reporting Cervical Cytology was created to reduce variation in Pap test interpretation by standardizing terminology, ensuring consistent test results across labs, and recommending appropriate next steps in care.
“For example, the Bethesda System (TBS) for Reporting Cervical Cytology was created to reduce variation in Pap test interpretation by standardizing terminology, ensuring consistent test results across labs, and recommending appropriate next steps in care [160].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [160]
The Abstract (page unavailable) says TBS was developed to address variability in cervical cytology reporting through terminology with clearer management thresholds. The section “Alignment of Management With Terminology” says TBS provided a framework for management guidelines. But “Bethesda Interobserver Reproducibilty Study (BIRST-II)” says some interlaboratory variability will always remain, so the paper does not support the claim that TBS ensures consistent test results across labs. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCytological classification was done according to the Bethesda system.
“Cytological classification was done according to Bethesda system [10].”
From HPV Genotypes distribution in Indian women with and without cervical carcinoma: Implication for HPV vaccination program in Odisha, Eastern India (2017) · cites this paper as [10]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 20 · Cited by 340
Research works printed but not linked: 19
- Solomon D. Foreword. In: Nayar R, Wilbur DC, eds. The Bethesda System for Reporting Cervical Cytology. Definitions, Cri- teria, and Explanatory Notes. 3rd ed. Springer; 2015.
- The 1988 Bethesda System for reporting cervical/vaginal cytologic diagnoses. National Cancer Institute Workshop. JAMA. 1989;262: 931-934.
- 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, NY: Springer-Verlag; 1994.
- Solomon D, Davey D, Kurman R, et al. The Bethesda System 2001: terminology for reporting the results of cervical cytology. JAMA. 2002;287:2114-2119.
- Solomon D, Nayar R, eds. The Bethesda System for Reporting Cervical Cytology. Definitions, Criteria, and Explanatory Notes. 2nd ed. New York, NY: Springer-Verlag; 2004.
- 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 cervi- cal cytology. Cancer Cytopathol. 2007;111:15-25.
- Davey DD, Neal MH, Wilber DC, Colgan TJ, Styler PE, Mody DR. Bethesda 2001 implementation and reporting rates: 2003 practices of participants in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology. Arch Pathol Lab Med. 2004;128:1224-1229.
- Schiffman M, Adrianza ME. ASCUS-LSIL Triage Study. Design, meth- ods and characteristics of trial participants. Acta Cytol. 2000;44:726-742.
- 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.
- Wright TC Jr, Massad SL, Dunton CJ, et al. 2006 Consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol. 2007;197:346-355.
- Ali SZ, Cibas ES, eds. The Bethesda System for Reporting Thyroid Cytopathology. New York, NY: Springer; 2010.
- Layfield LJ, Pitman MB, DeMay RM, et al. Pancreaticobiliary tract cytology: journey toward "Bethesda" style guidelines from the Papanicolaou Society of Cytopathology [serial online]. Cytojournal. 2014;11:18.
- Darragh TM, Colgan TJ, Cox JT, et al. The Lower Anogenital Squamous Terminology Standardization Project for HPV- Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Soci- ety for Colposcopy and Cervical Pathology. Arch Pathol Lab Med. 2012;136:1266-1297.
- Darragh TM, Colgan TJ, Cox JT, et al. The Lower Anogenital Squamous Terminology Standardization Project for HPV- Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Soci- ety for Colposcopy and Cervical Pathology. J Low Genit Tract Dis. 2012;16:205-242.
- Darragh TM, Colgan TJ, Cox JT, et al. The Lower Anogenital Squamous Terminology Standardization project for HPV- associated lesions: background and consensus recommendations from the College of American Pathologists and the American Soci- ety for Colposcopy and Cervical Pathology. Int J Gynecol Pathol. 2013;32:76-115.
- Stoler M, Bergeron C, Colgan TJ, et al. Epithelial tumours. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, eds. Chapter 7: Tumours of the Uterine Cervix. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon, France: IARC Press; 2014:172-198.
- Castle PE, Sideri M, Jeronimo J, Solomon D, Schiffman M. Risk assessment to guide the prevention of cervical cancer [serial online]. Am J Obstet Gynecol. 2007;197:356.e1-e6.
- Nayar R, Wilbur DC, eds. The Bethesda System for Reporting Cervical Cytology. Definitions, Criteria, and Explanatory Notes. 3rd ed. Springer; 2015.
- Stoler MH, Schiffman M. Interobserver variability of cervical cyto- logic and histologic interpretations: realistic estimates from the ASCUS-LSIL Triage Study. JAMA. 2001;285:1500-1505.
- Authors
- Nayar, R., & Wilbur, D. C.
- Affiliations
- Northwestern University (US)
- Harvard University (US)
- Corresponding author
- Nayar, Ritu
- Venue
- Cancer Cytopathology
- Publisher
- Wiley
- Published
- 2015-05
- Volume
- 123
- Issue
- 5
- Pages
- 271-281
- ISSN
- 1934-662X (ISSN-L)
- 1934-6638
- OpenAlex
- W2000351935
- Cited by
- 340
- References
- 20
- Citations by year
- 2026: 32 · 2025: 51 · 2024: 34 · 2023: 60 · 2022: 41 · 2021: 40 · 2020: 18 · 2019: 18 · 2018: 19 · 2017: 18 · 2016: 4 · 2015: 5
- FWCI
- 12.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer Cytopathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- Pap smear, Bethesda system, cervical cytology, cervical cancer screening, cytopathology reporting
- MeSH terms
- Biopsy, Needle, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms, Congresses as Topic, Cytodiagnosis, Female, Humans, Immunohistochemistry, Maryland, Neoplasm Invasiveness, Neoplasm Staging, Terminology as Topic, Sensitivity and Specificity, Vaginal Smears, Evidence-Based Medicine, Papillomavirus Infections, History, 20th Century, History, 21st Century, Early Detection of Cancer, Papanicolaou Test
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
