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May 2003
Special Section
Coming soon: new Bethesda System atlas and Web site
Ritu Nayar, MD
Diane Solomon, MD
A new edition of the Bethesda System atlas, widely known as the
“Blue Book,” will be published this fall and
contain the Bethesda 2001 terminology. A companion Web site is also in the works.
The Bethesda System for reporting cervical cytology results was developed in
1988 and revised in 1991 and in 2001 (The 2001 Bethesda System:
terminology for reporting results of cervical cytology. JAMA.
2002;287[16]:2114-2118). Its intent is to provide clear, uniform
terminology in communicating laboratory results that would also
be relevant for guiding clinical management. A companion atlas,
edited by Robert Kurman, MD, and Diane Solomon, MD, with several
dozen contributors, was published in 1994 to illustrate and disseminate
the morphologic criteria. The atlas is no longer current with the
2001 terminology, however, and the last decade has seen an increase
in the use of liquid-based technologies for cervical cancer screening,
which often yield different morphologic features from those of conventional smears.
To continue the tradition of making the Bethesda System terminology the product
of an increasingly numerous and diverse group of contributors, the
National Cancer Institute joined hands with the American Society
for Cytopathology to help disseminate Bethesda 2001. The ASC executive
board appointed an ad hoc task force in April 2002 to work in conjunction
with Dr. Solomon at the NCI to undertake a new edition of the Bethesda
System Blue Book and develop a Web-based atlas of images to complement the book version.
The Bethesda atlas will maintain its easy-to-read format with corresponding images,
and the content will be divided into chapters based on the major
Bethesda 2001 interpretive categories. The new edition will include
liquid-based cytology, morphologic criteria, and images, and there
will be new sections on ancillary testing, computer-assisted interpretation,
and anal cytology. Included also will be sample reports, selected
references, and an index as well as an educational notes and recommendations section.
At the same time the Bethesda 2001 atlas is being produced, the ASC task force
is developing a companion Web site. The Web site will contain images
from the new atlas and additional examples of Bethesda System interpretations,
and pertinent explanatory notes will be linked to the images. The
proposed Web site will allow global access to diagnostic images
and individual self-assessment. It is scheduled to be available
by fall of this year.
Dr. Nayar
is director of cytopathology, Northwestern Memorial Hospital, Chicago,
and chair of the ASC Bethesda 2001 Task Force. Dr. Solomon is a
senior investigator at the NCI, organizer of the Bethesda workshops,
and ASC past president. The NCI-ASC Working Group for Bethesda 2001
Atlas and Web Site is composed of members of the ASC Bethesda 2001
Task Force: George Birdsong, MD, adequacy; Jamie Covell, BS, CT
(ASCP), glandular lesions; Ann Moriarty, MD, endometrial cells;
Dennis O’Connor, MD, educational notes and recommendations;
Marianne Prey, MD, computer-assisted interpretation; Steve Raab,
MD, ancillary testing; Mark Sherman, MD, atypical squamous cells;
Sana Tabbara, MD, other malignant neoplasms; Tom Wright, MD, squamous
lesions; and Nancy Young, MD, non-neoplastic findings. ASC consultants
are ASC 2002/2003 presidents Diane Davey, MD, and David Wilbur,
MD. Information technology representatives are Mike Montgomery (NCI)
and Brandon Winbush (Northwestern University).
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