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Suggestions should be concise and consistent with clinical follow-up guidelines published by professional organizations (references to relevant publications may be included).

Educational notes and suggestions are a form of communication between laboratories and clinical providers and using them in cervical cytology reports is optional. Such notes should be directed to the health care provider who requested the test and should be formatted to be concise, clear and evidence-based as far as possible. Examples where Educational Notes may be used:

  • Negative cytology reports to highlight the limitations of cervical cytology.
  • Alerting clinicians to references containing consensus guidelines published by different professional organizations

Suggestions (previously referred to as “recommendations”) may be appended to cytology reports but their use is optional. Examples where Suggestions may be useful:

  • On unsatisfactory specimens; to improve the quality of a repeat specimen.
  • To identify patients with cytologic findings that may require further triage and management.
  • When morphologic findings are ambiguous.
  • In complex cases, if direct contact with the provider is not feasible, general statements such as “Suggest follow-up as clinically indicated” or “Further patient follow-up procedures are suggested as clinically indicated” can be used since the pathologist may not be aware of other pertinent clinical information.

Sample Reports: Can be found in the Bethesda Atlas. (Solomon D., Nayar R. (editors). The Bethesda System for Reporting Cervical Cytology, Second Edition. New York: Springer-Verlag, 2004.)

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