Abstract
Objective: The modified Papanicolaou classification is still generally used in the gynecologic cytology reporting system in Japan, whereas the Bethesda system (TBS) is widely used in many other countries. This study was conducted to elucidate understanding of the modified Pap classification by women who underwent screening for cervical cancer, cytotechnologists, pathologists, and gynecologists.
Study Design: Questionnaires on understanding of the modified Pap classification were administered to 182 women who underwent cervical cancer screening, 62 cytotechnologists, 71 gynecologic and non-gynecologic cytopathologists, and 30 gynecologist (non-cytopathologists). The cytotechnologists, gynecologist, and pathologists used the modified Pap classification to interpret the Pap smears.
Results: The women who underwent cervical cancer screening and the gynecologist (non-cytopathologists) requested an interpretation of the Papanicolaou smear report that was easier to understand. Several institutions used further modified classification, such as classes II and II′ or III a, III b, or III. The cytologic diagnosis of mild dysplasia and severe dysplasia closely corresponded to the classifications III a and III b, respectively, while koilocytosis corresponded to class II or III a, and moderate dysplasia to III a, III b, or III. Atypical glandular cells and atypical non-epithelial cells corresponded to class III a, III b, or III.
Conclusion: Since the modified Pap classification used in Japan corresponded to the category result, there is no consensus among the cytopathologists and cytotechnologists in this classification concerning the estimated cytodiagnosis. A new report form should be prepared based on the TBS, because the estimated cytopathological diagnosis is used by the description form and specimen type (conventional or liquid-based preparation), and the specimen’s adequacy is reported in the TBS.
