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Letters
March 8, 2000

Follow-up of Unsatisfactory Papanicolaou Test Results

Author Affiliations
 

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(10):1290-1291. doi:10.1001/jama.283.10.1287

To the Editor: Use of the Papanicolaou (Pap) test has resulted in a 6- to 10-fold decline in the rate of invasive cervical cancer in screened populations.1 The Bethesda System (TBS) was developed in 1988 and revised in 1991 to clarify the varied terminology for cytological findings.2,3 An important aspect of TBS is the evaluation of the specimen for adequacy, which is reported as satisfactory, satisfactory but limited (with description), or unsatisfactory. Retrospective studies have indicated that unsatisfactory Pap test results are associated with a high incidence of subsequent cervical malignancy or premalignant epithelial abnormalities.46 By judging the adequacy of the Pap test, TBS aims to decrease false-negative reports. Due to concerns that introduction of TBS terminology has confused practitioners and resulted in inadequate follow-up of abnormal test results, we reviewed the management of patients at a major teaching institution who had Pap test results that were diagnosed as "unsatisfactory for evaluation."

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