The Pap Test and Bethesda 2014. "The reports of my demise have been greatly exaggerated." (after a quotation from Mark Twain)

Acta Cytol. 2015;59(2):121-32. doi: 10.1159/000381842. Epub 2015 May 19.


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. The Bethesda conferences and their ensuing output have also set the stage for standardization of terminology across multiple organ systems, including both cytology and histology, have initiated significant research in the biology and cost-effective management for human papillomavirus-associated anogenital lesions, and, finally, have fostered worldwide unification of clinical management for these lesions. 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.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Neoplasm Grading
  • Observer Variation
  • Papanicolaou Test / standards*
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Reproducibility of Results
  • Terminology as Topic
  • Uterine Cervical Dysplasia / classification
  • Uterine Cervical Dysplasia / pathology*
  • Uterine Cervical Neoplasms / classification
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears / standards*