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. 2002;287(16):2114-2119 (doi:10.1001/jama.287.16.2114)JAMADiane Solomon; Diane Davey; Robert Kurman; et al.

Results of Cervical CytologyThe 2001 Bethesda System: Terminology for Reporting

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CONSENSUS STATEMENT

The 2001 Bethesda SystemTerminology for Reporting Results of Cervical CytologyDiane Solomon, MD

Diane Davey, MD

Robert Kurman, MD

Ann Moriarty, MD

Dennis OConnor, MD

Marianne Prey, MD

Stephen Raab, MD

Mark Sherman, MDDavid Wilbur, MD

Thomas Wright, Jr, MD

Nancy Young, MD

for the Forum Group Members andthe Bethesda 2001 Workshop

BACKGROUNDThe Bethesda System for reporting theresults of cervical cytology was devel-oped as a uniform system of terminol-ogy that would provide clear guidance

for clinical management.

1

The firstworkshop was held in 1988, to reducewidespread confusion among labora-tories and clinicians created by the useof multiple classification systems andinconsistently defined numerical grad-ing conventions.

The most important contribution ofthe Bethesda System was the creation ofa standardized framework for labora-tory reports that included a descriptivediagnosis and an evaluation of speci-men adequacy. While not everyoneagreed with everydetail of that initial ef-

fort, the recommendations of the 1988workshop received widespread accep-tance in practice.2 A second workshopwas held in 1991 to modify theBethesdaSystem based on actual laboratory andclinical experience after its implemen-

tation.3 Currently, more than 90% of USlaboratories use some form of the 1991BethesdaSystem in reportingcervical cy-tology.4 With the increased utilizationof new technologies and recent find-ings from research studies, 2001 was

considered an opportune time to re-evaluate the Bethesda System.

Bethesda 2001 Process

Eight months prior to the Bethesda2001 Workshop, 9 forum groups (listed

Author Affiliations: Division of Cancer Prevention, Na-tional Cancer Institute, Bethesda, Md (Dr Solomon); De-partment of Pathology andLaboratoryMedicine, Uni-versity of Kentucky Medical Center, Lexington (DrDavey); Departments of Gynecology andObstetrics and

Pathology, Johns Hopkins Hospital, Baltimore, Md (DrKurman); AmeriPath Indiana, Indianapolis (Dr Mori-arty); Clinical Pathology Associates, Louisville, Ky (DrOConnor); Quest Diagnostics Incorporated, St Louis,Mo(Dr Prey); Department of Pathology, Allegheny Hos-pital, Pittsburgh, Pa (Dr Raab); Division of Cancer Epi-demiology and Genetics, National Cancer Institute,Bethesda, Md (Dr Sherman); Department of Pathol-ogy,Massachusetts General Hospital, Boston(Dr Wilbur);Department of Pathology, Columbia University, NewYork, NY (Dr Wright); and Department of Pathology,FoxChaseCancer Center,Philadelphia, Pa (DrYoung).

Financial Disclosure: DrWrightwas theprincipal in-vestigatorof theclinical trials investigating HPVDNAtesting and liquid-based cytology funded by DigeneCorp and Cytyc Corp via formal grants to ColumbiaUniversity. Dr Wright hasno financial or equityinter-

est in, ongoing consultancy with, or membership onthe scientific advisory board of Digene Corp, whichmakes the only FDA-approved HPV DNA test in theUnited States. Dr Wright currentlyserveson thespeak-ersbureau of Cytyc Corpand TripathInc, which makeliquid-based cytology test kits.Forum Group Members are listed at the end of thisarticle.C orresponding A uthor and R eprints: DianeSolomon, MD, EPN Room 2130, 6130 ExecutiveBlvd, Bethesda, MD 20892 (e-mail: [email protected]).

Objectives The Bethesda 2001 Workshop was convened to evaluate and updatethe 1991 Bethesda System terminology for reporting the results of cervical cytology.A primary objective was to develop a new approach to broaden participation in theconsensus process.

Participants Forum groups composed of 6 to 10 individuals were responsible fordeveloping recommendations for discussion at the workshop. Each forum group in-cluded at least 1 cytopathologist, cytotechnologist, clinician, and international repre-sentative to ensure a broad range of views and interests. More than 400 cytopatholo-gists, cytotechnologists, histopathologists, family practitioners, gynecologists, public

health physicians, epidemiologists, patient advocates, and attorneys participated in theworkshop, which was convened by the National Cancer Institute and cosponsored by44 professional societies. More than 20 countries were represented.

Evidence Literature review, expert opinion, and input from an Internet bulletin boardwere all considered in developing recommendations. The strength of evidence of thescientific data was considered of paramount importance.

Consensus Process Bethesda 2001 was a year-long iterative review process. AnInternet bulletin board was used for discussion of issues and drafts of recommenda-tions. More than 1000 comments were posted to the bulletin board over the courseof 6 months. The Bethesda Workshop, held April 30-May 2, 2001, was open to thepublic. Postworkshop recommendations were posted on the bulletin board for a lastround of critical review prior to finalizing the terminology.

Conclusions Bethesda 2001 was developed with broad participation in the consen-sus process. The 2001 Bethesda System terminology reflects important advances in

biological understanding of cervical neoplasia and cervical screening technology.JAMA. 2002;287:2114-2119 www.jama.com

See also pp 2120 and 2140.

2114 JAMA,April 24, 2002Vol 287, No. 16 (Reprinted) 2002 American Medical Association. All rights reserved.

http://jama.ama-assn.org/http://jama.ama-assn.org/http://jama.ama-assn.org/http://jama.ama-assn.org/


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at the end of the article) were estab-lished to draft recommendations formodifying the Bethesda System. Aprimary objective was to broadenparticipation by using the Internetin the premeeting development pro-

cess. A dedicated Web site (http://bethesda2001.cancer.gov) withan elec-tronic bulletin board was established toseek input and critiques of draft rec-ommendations. In total, more than1000individual commentswerepostedto the bulletin board.

The workshop was held April 30-May 2, 2001, with more than 400 par-ticipants, including pathologists, cyto-technologists, clinicians, and patientadvocates. Forty-four professional so-cieties, representing more than 20 coun-tries, were cosponsors (BOX1). More

than 20 national and international so-cieties have endorsedthe 2001 BethesdaSystem at this writing. The followingsummary highlights the most clinicallyrelevant changes to the Bethesda Sys-tem (BOX2); a more detailed text willbe published in specialty journals.

THE 2001 BETHESDA SYSTEMSpecimen Adequacy

Evaluation of specimen adequacy isconsidered by many to be the singlemost important quality assurance com-

ponent of the Bethesda System. Origi-nally, in 1988, specimen adequacy wascategorized as satisfactory, less thanoptimal (renamed satisfactory butlimited by . . . in 1991), or unsatis-factory. The middle category was usedmost often for cases lacking endocer-vical or squamous metaplastic cells asevidence of transformation zone sam-pling, but which were otherwise sat-isfactory. The 2001 Bethesda Systemmaintains the satisfactory for evalua-tion and unsatisfactory for evalua-

tion categories, but eliminates satis-factory but limited by . . . because theterm wasconsidered confusing to manyclinicians and prompted unnecessaryrepeat testing. Nevertheless, provid-ing informationon transformation zonesampling has value in improving over-all specimen quality and encourages ef-forts to optimize sample collection.

Minimalsquamous cellularity require-ments for a specimen to qualify as sat-isfactory differ depending on speci-men type: an estimated 8000 to 12 000well-visualized squamous cells for con-ventional smears and 5000 squamouscells for liquid-based preparations. Tech-

niques for evaluating cellularity will bepresented in future publications.

A notation is made regarding thepresence or absence of an endocervical/transformation zone component forspecimenswith adequate squamous cel-lularity. The numeric criterion for a

BOX1. Bethesda 2001 Workshop Cosponsors

American Cancer Society*

American College Health Association*

American College of Obstetricians and Gynecologists*

American Social Health Association*

American Society of Cytopathology*

American Society for Colposcopy and Cervical Pathology*American Society of Clinical Pathologists*

American Society for Cytotechnology*

Asociacion Mexicana de PatologosAssociation of Reproductive Health ProfessionalsAssociation of Womens Health, Obstetric and Neonatal NursesAustralian Society of CytologyBritish Society for Clinical CytologyCanadian Society of Cytology Societe Canadienne de Cytologie*

Centers for Disease Control and PreventionChinese Society of CytopathologyCollege of American Pathologists*

Deutsche Gesellschaft fur ZytologieFood and Drug Administration

Gynecologic Oncology Group, ACOG*

Health Care Financing AdministrationInternational Academy of CytologyInternational Society of Gynecological PathologistsIrish Association for Clinical Cytology*

Japanese Society of Clinical CytologyKorean Society for CytopathologyMagyar Onkologusok Tarsasaga-Cytodiagnosztikai SectioNational Committee for Clinical Laboratory StandardsNurse Practitioners in Womens HealthOesterreichische Gesellschaft fuer Zytologie*

Papanicolaou Society of Cytopathology*

Planned Parenthood FederationRomanian Society of CytologySociedad Argentina de Citologia

Sociedad Chilena de CitologiaSociedad Espanola de Citologia*

Sociedad Peruana de CitologiaSociedade Boliviana de CitologiaSociedade Brasileira de CitopatologiaSocieta Italiana di Anatomia Patologica e Citopatologia DiagnosticaSociete Belge de Cytologie CliniqueBelgische Vereniging voor Klinische

Cytologie*

Societe Francaise de Cytologie Clinique*

Society of Gynecologic Oncologists*

Suid Afrikaanse Vereniging vir Kliniese SitologieSouth African Society ofClinical Cytology*

*Indicates that the society has endorsed the 2001 Bethesda System.

THE 2001 BETHESDA SYSTEM

2002 American Medical Association. All rights reserved. (Reprinted) JAMA, April 24, 2002Vol 287, No. 16 2115



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transformation zone component is un-changed from the 1991 Bethesda Sys-temthere should be at least 10 well-

preserved endocervical or squamousmetaplastic cells; however, clusters areno longer required.

Comments on quality indicatorssuchas partially obscuring inflammation orblood may also be added to the satis-factory designation. A specimen is con-sidered partially obscured when 50%to 75% of the epithelial cells cannot be

visualized. Specimens with more than75%of epithelial cells obscured areun-satisfactory.

Specimens that cannot be acces-sioned by the laboratory, if unlabelledfor example, are also designated as un-satisfactory; these are distinguishedfrom specimens that have been pro-cessed by the laboratory and deter-mined to be unsatisfactory followingmicroscopic evaluation.

General Categorization

Thegeneral categorizationis an op-

tional component of the Bethesda Sys-tem,designedto allow clinicians and/ortheir staff to triage reports readily. Theprevious category headings ofwithinnormal limits and benign cellularchangeshave been combined into asingle categorynegative for intraepi-thelial lesion or malignancy.In this way,reactive changes are more clearly des-ignated as negative. Other has beenadded as a category for cases in whichthere are no morphological abnormali-ties in thecells per se;however, thefind-

ings may indicate some increased risk:for example, benign-appearingendo-metrial cells in a woman40 years ofage(see below).

These categories are mutually exclu-sive; therefore, if several findingsare present, the general categorizationis based on the most clinically sig-nificant result (eg, epithelial cellabnormality).

Interpretation/Result

The workshop participants unani-

mously supported the view that cervi-cal cytology is primarily a screening test,which in some instances may serve asa medical consultation by providing aninterpretation that contributes to a di-agnosis. However, a patients final di-agnosis, and therefore management,must integrate clinical and laboratoryresults. Therefore, in the2001 Bethesda

BOX2. The 2001 Bethesda System (Abridged)

SPECIMEN ADEQUACY

Satisfactory for evaluation (note presence/absence of endocervical/transformation zone component)

Unsatisfactory for evaluation . . . (specify reason)

Specimen rejected/not processed (specify reason)Specimen processed and examined, but unsatisfactory for evaluation ofepithelial abnormality because of (specify reason)

GENERAL CATEGORIZATION (Optional)

Negative for intraepithelial lesion or malignancyEpithelial cell abnormalityOther

INTERPRETATION/RESULT

Negative for Intraepithelial Lesion or MalignancyOrganisms

Trichomonas vaginalisFungal oganisms morphologically consistent withCandidaspeciesShift in flora suggestive of bacterial vaginosisBacteria morphologically consistent withActinomycesspecies

Cellular changes consistent with herpes simplex virusOther non-neoplastic findings (Optional to report; list not comprehensive)

Reactive cellular changes associated withinflammation (includes typical repair)radiationintrauterine contraceptive device

Glandular cells status posthysterectomyAtrophy

Epithelial Cell AbnormalitiesSquamous cell

Atypical squamous cells (ASC)of undetermined significance (ASC-US)cannot exclude HSIL (ASC-H)

Low-grade squamous intraepithelial lesion (LSIL)

encompassing: human papillomavirus/mild dysplasia/cervicalintraepithelial neoplasia (CIN) 1High-grade squamous intraepithelial lesion (HSIL)

encompassing: moderate and severe dysplasia, carcinoma in situ;CIN 2 and CIN 3

Squamous cell carcinomaGlandular cell

Atypical glandular cells (AGC) (specify endocervical, endometrial, or nototherwise specified)

Atypical glandular cells, favor neoplastic (specify endocervicalor not otherwise specified)

Endocervical adenocarcinoma in situ (AIS)Adenocarcinoma

Other(List not comprehensive)Endometrial cells in a woman 40 years of age

AUTOMATED REVIEW AND ANCILLARY TESTING (Include as appropriate)

EDUCATIONAL NOTES AND SUGGESTIONS (Optional)





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System the termdiagnosishas beenreplaced by interpretation or re-sultto convey that cervical cytologyprovides an interpretation of morpho-logical findings that must be inte-grated into a clinical context.

Negative for Intraepithelial Lesionor Malignancy. Specimens for which noepithelial abnormality is identified arereported asnegative for intraepithe-lial lesion or malignancy.Reportingnon-neoplastic findings, other than thelisted organisms, is optional; Box 2 in-cludes a partial list of findings.

Epithelial Cell Abnormalities.Atypi-cal Squamous Cells. The 1988 BethesdaSystem included the term atypicalsquamous cells of undetermined sig-nificance(ASCUS) to designatecel-lular abnormalities that were more

marked than those attributable to re-active changes but that quantitativelyor qualitatively fell short of a defini-tive diagnosis ofsquamous intraepi-thelial lesion (SIL). Pathologists wereencouraged to qualify ASCUS with re-spect to whether a reactive process orSIL was favored. In practice, patholo-gists reported a significant proportionof smears asASCUS, not otherwisespecified.

Whenthe 1988Bethesda System wasdrafted, clinical management in the

United States focused on identifying allSIL, including low-grade SIL (LSIL),based on the view that all grades of SILrepresented closely linked precursorsthat required colposcopy and treat-ment. However, there has been a shiftin the UnitedStateswith regardto man-agement based on the recognition thatmost LSIL, especially in young women,represents a self-limited human papil-lomavirus (HPV) infection.5 Accord-ingly, the current emphasis is on de-tection and treatment of histologically

confirmed high-grade disease (particu-larly cervical intraepithelial neoplasia[CIN] 3). Therefore, it is logical for theASC category qualifiers to emphasizethe importance of detecting high-grade SIL (HSIL), which has emergedas the central purpose of screening.

At the 2001 workshop, a small mi-nority of workshop participants ar-

gued for elimination of the ASCUS cat-egory. However, the participantsdecided that it was essential to main-tain an equivocal category because ofthe large number of women with un-derlying CIN 2 and 3 who are discov-

ered through a workup for an equivo-cal cytological reading. Estimatessuggest that 10% to 20% of womenwithASC have underlying CIN 2 or 3 andthat 1 in 1000 may have invasive can-cer.6 The elimination of an equivocalcytology category seemed imprudentgiven thehigh expectations for very sen-sitive cervical cytological screening inthe United States.

The 2001 Bethesda System differs inseveralfundamental ways with regardtoreporting equivocalresults. First,atypi-cal squamous cellsare now qualified

as of undetermined significance(ASC-US)or cannot exclude HSIL(ASC-H). The qualifierundeterminedsignificance was retained to empha-size that some cases of ASC-US are as-sociatedwith underlying CIN2 or 3.Sec-ond, ASC isnot a diagnosis of exclusion;all ASC is considered to be suggestiveof SIL. Accordingly, the category ofASCUS, favor reactive was elimi-nated. Pathologists are encouraged tojudiciously downgrade to negative forintraepithelial lesion or malignancya

portion of the cases previously termedASCUS favor reactive.

The new term ASC-H is thought toinclude approximately 5% to 10% ofASC cases overall.7-9 This category re-flects a mixture of true HSIL and itsmimics. Although the interpretation isnothighlyreproducible among patholo-gists, studies suggest that ASC-H has apositive predictive value for histologi-cal CIN 2 or 3 that is intermediate be-tween ASC-US and HSIL. It is hopedthat by highlighting such cases, ASC-H

will aid in more rapid detection andtreatment of some cases of CIN 2 and3. However, the equivocal nature of theASC-H designation should encouragecomprehensive review of all pathol-ogy and colposcopic findings prior toperforming a diagnostic loop electro-surgical excision procedure in womenwith negative histology results.

Squamous Intraepithelial Lesions. The1988 Bethesda System introduced a2-tiered terminology, LSIL andHSIL, forreporting the spectrum of noninvasivesquamous cervical abnormalities.

After thorough consideration by the

Bethesda 2001 Workshop, the 2-tieredLSIL/HSIL terminology remains un-changed.

The dichotomous division of SIL re-flects the substantial virological, mo-lecular, and clinical evidence that LSILis generally a transient infection withHPV, while HSIL is more often associ-ated with viral persistence and higherrisk for progression.10-13 In addition,data from theASCUS LSIL TriageStudydemonstrate the following: (1) LSIL vsHSIL is a fairly reproducible diagnos-tic breakpoint, (2) subdividing cyto-

logical HSIL into moderate and severedysplasia orCIN2 and 3 isnot veryre-producible, and (3) HPV cytopathiceffect cannot be reliably separated frommild dysplasia or CIN 1 (M. Schiff-man, written communication, 2001).

However,the3-tieredCIN1-2-3 des-ignations may be helpful in managingsome individual patients, in correlat-ing cytopathologic and histopatho-logic findings, or in reporting cytol-ogy results outside the United States.Some members of the European cyto-

pathology community in particular fa-vor use of CIN terminology. As in pre-vious versions of the Bethesda System,CIN or dysplasia terminology can beused, either as a substitute for SIL oras an additional descriptor.AtypicalGlandular Cells.The classi-

fication of glandular abnormalities hasbeen significantly revised in the 2001Bethesda System, reflecting a reap-praisal of the strengths and weak-nesses of cytology in assessing thesefindings.

The term atypical glandular cells ofundetermined significance (AGUS) hasbeen eliminatedto avoid confusion withASC-US. Glandular cell abnormalitiesare classified as atypical endocervi-cal, endometrial, or glandular cells.

In the majority of cases, morpho-logical features permit differentiationbetween atypical endometrial and en-





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docervical cells.14 The management ofpatients with glandular abnormalitiesmayvary significantlydepending on celltype and justifies making this distinc-tion when possible. The termatypi-cal epithelial cells may be used for

cases where a squamous vs glandularorigin cannot be determined.Thefinding of atypical glandular cells

(AGC) is important clinically becausethe percentage of cases associated withunderlying high-gradedisease is higherthan for ASC-US. On follow-up, high-grade lesions (either squamous or glan-dular) may be seen in 10% to 39% ofsuch cases.15-17 Based on such data, thequalifierfavor reactive was consid-ered misleading and it has been elimi-nated: such cases are now included inthe AGC category.

In the 1991 terminology, adenocar-cinoma in situ (AIS) was included inAGUS,probably neoplastic. Since thattime, studies have clearly documentedpredictive value and reproducibility ofproperly applied cytological criteria forthisinterpretation.18-20 Endocervical ad-enocarcinoma in situ is therefore nowa separate category. However, there isconsiderable morphological overlap be-tween AIS and well-differentiated inva-siveendocervical adenocarcinoma;a per-centage of cases interpreted as AIS will

demonstrate invasion on histologicalevaluation.

For cases showing some featuressug-gestive of, but not sufficient to reach aninterpretation of AIS, an intermediatecategory ofatypical endocervical cells,favor neoplasticconveys a significantlevelof concern.There is no basis for es-tablishing a category ofendocervicalglandular dysplasia or low grade glan-dular intraepithelial lesion.21 A mor-phological spectrum of bona fide pre-cursors ofAIS has not been identifiedfor

endocervical glandular lesions.Other. In the previous version of theBethesda System, the finding of endo-metrial cells wasreported only for post-menopausal women. However, in the2001 Bethesda System, endometrialcells are noted if the woman is 40yearsof age or older, regardless of the dateof the last menstrual period, because

menstrual/menopausal status, exog-enous hormone therapy, and otherclinical risk factors are often un-known or unclear. Although usuallybenign in nature, identification ofendometrial cells, particularly if not as-

sociated with menses or after meno-pause, may indicate risk for an endo-metrial abnormality.22-25 As noted above,this finding is categorized asother.

It is important to emphasizethatcer-vical cytology is primarily a screeningtest for squamous epithelial lesions andsquamous cancer. It is unreliable for thedetection of endometrial lesions andshould not be used to evaluate sus-pected endometrial abnormalities.

Automated Reviewand Ancillary Testing

Automated review and ancillary test-ing are elements of the report that areincluded as appropriate. For slidesscanned by automated computer sys-tems, the instrumentation used and theautomated review result should be in-cluded in the cervical cytology report.If an ancillary molecular test has beenperformed, the type of assay should bespecified in addition to the results. Ide-ally, cytology and ancillary testing re-sults should be reported concur-rently; however, this may not alwaysbe

possible.

Educational Notes and Suggestions

Written comments regarding the va-lidity and significance of a cytology re-sult are the responsibility of the pa-thologist and are directed to theclinician who requested the test. Thelaboratory should avoid communi-cating results directly to the patient, asthis may interfere with the patient-clinicianrelationship. Direct contactbe-tween the patient and the laboratory

may be acceptable, however, if specifi-cally requested by the clinician.The use of educational notes or sug-

gestions is optional. If used, the for-mat and style may vary depending onthe preferences of the laboratory anditsclinicians. Nevertheless, any com-ments should be carefully andthought-fully crafted, concise but not direc-

tive, consistent with clinical follow-upguidelines published by professionalor-ganizations, and phrased in the form ofa suggestion. A qualifying phrase (eg,as clinically indicated) should gen-erally be added since the pathologist

maybe unaware of other pertinent clini-cal information. One study has shownthat including suggestions for furtherevaluation improves the likelihood thatappropriate follow-up occurs.26 Pro-viding references for consensus clini-cal follow-up guidelines for abnormalcervical cytology results published bymedical organizations (eg, AmericanCollege of Obstetricians and Gynecolo-gists, American Society for Colpos-copy and Cervical Pathology) may alsobe helpful.27

SUMMARYThe goal of the Bethesda System is topromote more effective communica-tion of cervical cytology results fromthelaboratory to clinicians. The 2001 re-vision of the terminology was devel-oped through a process designed to in-corporate new scientific data andencourage input from a broad range ofindividuals involved in cervical can-cer screening. Management guide-lines for women with abnormal cytol-ogy results, based on the 2001 Bethesda

System, have been developed at a con-sensus conference sponsored by theAmerican Society for Colposcopy andCervical Pathology.28 Such collabora-tive and integrated development of re-porting terminology and managementguidelines should provide more uni-form, evidence-based care of womenwith cervical abnormalities.

The Forum Group Members include the following:Specimen Adequacy: Diane D. Davey, MD, GeorgeBirdsong, MD, Henry W. Buck, MD, Teresa Darragh,MD, Paul Elgert, CT(ASCP), Michael Henry, MD,Heather Mitchell, MD, Suzanne Selvaggi, MD; Be-

nign Cellular Changes and Infections:Nancy Young,MD, Marluce Bibbo, MD, Sally-Beth Buckner, CT(ASCP), Terence Colgan, MD, Dorothy Rosenthal, MD,Edward Wilkinson,MD; ASCUS: MarkSherman, MD,Fadi Abdul-Karim, MD, Jonathan Berek, MD, Patri-cia Braly, MD, Robert Gay, CT(ASCP), Celeste Pow-ers, MD,MarySidawy, MD,SanaTabbara, MD;AGUS:David Wilbur, MD, David Chhieng, MD, J. ThomasCox, MD, Jamie Covell, BS, CT(ASCP), Barbara Gui-dos, SCT(ASCP), Kenneth Lee, MD,Dina Mody, MD;HPV Triage: Stephen Raab, MD, Karen Allen, CT(ASCP), Christine Bergeron, MD, PhD, DianeHarper,





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MD, Walter Kinney, MD, AlexanderMeisels, MD; En-dometrial Cells:Ann Moriarty, MD, Edmund Cibas,MD,Gary Gill, CT(ASCP), MegMcLachlin, MD,EllenSheets, MD, Theresa Somrak, CT(ASCP), RosemaryZuna, MD; LSIL /HSIL: TomWright, MD,Richard De-May, MD,Rose Marie Gatscha, CT(ASCP), Lydia How-ell, MD,RonaldLuff,MD, MPH, VolkerSchneider,MD,LeoTwiggs, MD; Computer-Assisted Diagnosis:Mari-anne Prey, MD,Mike Facik,CT(ASCP), Albrecht Reith,

MD,Max Robinowitz,MD, MaryRubin, NP,PhD, SueZaleski, SCT(ASCP);Recommendations, EducationalNotes, and Disclaimers:DennisOConnor, MD, Mar-shall Austin, MD, PhD, Lisa Flowers, MD, BlairHolladay, PhD, CT(ASCP), Dennis McCoy, JD, PaulKrieger, MD, Gabriele Medley, MD, Jack Nash, MD,Mark Sidoti, JD;Electronic Bulletin Board Program-mer:Lomi Kil, BA.

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