Identifying Women With Cervical Neoplasia

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Abstract
Papanicolaou (Pap) cervical cytology screening has helped reduce cervical cancer rates dramatically since its implementation in the 1950s. Pap test reporting classifications have evolved and been refined, with the current standard being the Bethesda system.1 The management of equivocal Pap test abnormalities remains a large and complex clinical and public health challenge. The most common abnormal Pap test result is one of uncertainty, atypical squamous cells of undetermined significance (ASCUS). In the United States, about 2 million ASCUS Pap reports occur each year. A survey of Pap smear reporting rates in US cytology laboratories found a median of 2.9% ASCUS results, with 10% of laboratories reporting ASCUS rates of more than 9%.2

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