In December, 1988, the National Cancer Institute sponsored a workshop to develop uniform descriptive diagnostic terminology for cervicovaginal cytopathology to replace the Papanicolaou Class designations. The proceedings of that meeting, known as the 1988 Bethesda System, have had a significant impact on the practice of gynecologic cytopathology. A survey conducted in early 1991 by the College of American Pathologists, revealed that 87% of the labs surveyed had already implemented TBS (in whole or in part), or were planning to do so in the near future. Two years after its initial publication, the time had come to critically evaluate the advantages and disadvantages of TBS in actual laboratory practice. A """"""""Second Conference"""""""" on The Bethesda System was held April 29 and 30, 1991, at the National Institutes of Health in Bethesda, Maryland with a capacity attendance. The two day meeting organized by the Cytopathology Section, provided open exchange of data, lively debate and a forum for critical analysis of TBS. An Editorial Committee was established to revise TBS terminology based on this input as well as written commentaries, scientific data, and laboratory surveys. The revised TBS has been significantly streamlined and simplified. A Criteria Committee is completing a reference atlas which will include morphologic criteria and accompanying photomicrographs. I have been an active participant in both committees. In addition, I have been involved as a cytopathology resource person in numerous meetings and working groups including: The College of American Pathologist's Cytopathology Committee; Executive Committee of the American Society of Cytology; several CDC workshops on quality assurance in breast and cervical cancer; a CDC expert panel on cervical disease in HIV-infected women; a videodisc collaboration with the National Library of Medicine on cervical cancer; and the development of the National Strategic Plan for Breast and Cervical Cancer.
