Physician attitudes toward the Bethesda System of reporting cervical cytology

The purpose of this investigation was to determine family physicians' and gynecologists' attitudes toward and understanding of the Bethesda System, a new cervical cytology classification and reporting system.

A convenience sample of 159 family physicians and gynecologists completed a questionnaire that assessed attitudes, knowledge, and opinions about the Bethesda System.

Compared with family physicians, gynecologists thought the Bethesda System was more likely to cause patient management problems (p < 0.001) and preferred not to combine viral cytologic effects with mild dysplasia when reporting a low-grade squamous intraepithelial lesion (p < 0.004). However, increased understanding of the system by physicians correlated with greater preference for the Bethesda System (p < 0.02). In this exploratory study, family physicians, rather than gynecologists, were more inclined to use the Bethesda System and perceived it as a means to reduce clinical evaluation and patient management problems. Gynecologists reported a fuller understanding of the Bethesda System, yet they were more critical of the cytology categorizations. Within each specialty, greater understanding of the Bethesda System led to its wider acceptance.