Rate of endometrial adenocarcinoma in women screened before and after implementation of the Bethesda 2001 reporting system.

OBJECTIVE To assess the impact of the recommendation of the 2001 Bethesda System to report all benign-appearing endometrial cells seen in women aged > or = 40 years on the frequency with which endometrial carcinomas are potentially detected as a consequence of Pap test reports that mention endometrial cells. STUDY DESIGN We identified all women diagnosed with endometrial adenocarcinoma who also had a Pap test during the preceding 6 months. The search was performed for 3-year periods before and after the date of implementation of Bethesda 2001. RESULTS Benign endometrial cells were reported for 589 women in the 3 years before Bethesda 2001 and for 3,810 women in the 3 following years. The number of endometrial malignancies found on follow-up in these women decreased from 8 in the 3 years before Bethesda 2001 to only 4 subsequently. The frequency of reporting atypical or malignant glandular cells, as well as the likelihood of finding endometrial malignancy on follow-up, did not significantly change. CONCLUSION Despite a 6.5-fold rise in the frequency of reporting benign endometrial cells after Bethesda 2001, the frequency of subsequent diagnosis of endometrial malignancies did not in-crease.