In 2014 The Bethesda System for reporting of Pap smears was revised. These revisions were published in 2015. We have modified our diagnostic categories to reflect these changes.
Reporting of endometrial cells in women over 40 years of age was changed to reporting endometrial cells in women over 45 years of age.
Recommendations were made to discontinue the use of Low grade squamous intraepithelial lesion (LSIL) with a few cells suggestive of high grade squamous intraepithelial lesion (HSIL). Based on the recommendations in Bethesda 2014, these lesions will be diagnosed as ASC-H in a background of LSIL.
The recommendation clarifies the treatment algorithm for these patients. These patients should have colposcopy. In our experience over 50% of these patients have biopsies diagnosed as high-grade squamous intraepithelial lesion (HSIL).