Editorial

Womens healthcare issues have made big headlines this summer in both the trade and consumer press, as well as around the water cooler. New cervical cytology reporting terminology, new management guidelines for patients with abnormal Pap smears, as well as new data concerning the role of human papillomavirus in cervical cancer, have each made a significant impact on the status quo. Then, in July, the astounding alert about an apparent danger involved in hormone replacement therapy came thundering through the media, causing menopausal women to wonder if they were doomed to an existence boobytrapped by unrelieved hot flashes and night sweats.Cervical cytology issues affect the lives of thousands of medical laboratory professionals, many of whom happen to be women.Some 50 million cervical cancer-screening tests are performed each year in the U.S. The results of each test must be communicated to physicians. This year, there has been a change in the way those results are reported, with the release of the revised Bethesda System. Originally developed in 1988 as a uniform system of terminology to provide clear guidelines for clinical management, the Bethesda System was last revised in 1991. The new System was developed as a result of last years Bethesda 2001 Workshop, sponsored by the National Cancer Institute and co-sponsored by 44 professional societies. During the six-month period following the workshop, more than 1,000 comments were posted to an Internet bulletin board, and each was considered when the terminology was revised. Finally, the new Bethesda System was announced in the April 24 issue of the Journal of the American Medical Association. A conference sponsored last September by the American Society for Colposcopy and Cervical Pathology was the culmination of a project that resulted in the development of evidence-based consensus guidelines for the management of women suffering from cervical cytological abnormalities and precursors of cervical cancer.Important data about the use of HPV testing was presented by a study sponsored by the National Cancer Institute, the Atypical Squamous Cells of Undetermined Significance-Low-Grade Squamous Intraepithelial Lesion Triage Study. Because the NCI recognizes HPV as the major cause of cervical cancer, molecular HPV testing will become a major screening and management tool.What does all of this mean to you in your lab? Youll be using a new system of reporting cervical cancer screening results to the docs. Youll be doing more and more HPV testing. And if youre a woman close to middle age, you may be fighting to turn down the lab thermostat while youre at it.Celia Stevens
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