Cervical Cancer Screening in Canada: 1998 Surveillance Report

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Appendix B

Classification Systems

Provinces in Canada use various cervical cytology classification systems. To display data for comparison, the various systems were converted to the Bethesda Classification System. Table B1 shows the conversion system used for the data provided. Table B2 shows for each province, the actual categories that were used for conversion of the data provided.

Table B1 : Cervico-vaginal Reporting Terminologies¹

The Bethesda System	CIN/Modified Walton System
Unsatisfactory: state reason	Unsatisfactory : state reason
Within normal limits	No abnormal cells, metaplasia noted
Benign cellular changes Trichomonas vaginalis Fungal organisms morphologically consistent with Candida spp. Cellular changes associated with herpes simplex virus	Abnormal cells consistent with reactive atypia (non-dysplastic) Trichomonas effect Yeast effect Viral effect (herpes type)
Benign cellular changes	Abnormal cells consistent with reactive atypia (non-dysplastic)
Reactive cellular changes associated with inflammation radiation other	Inflammatory effect Irradiation effect Other
ASCUS*	Abnormal cells consistent with atypia (possibly dysplastic) Atypical metaplasia Atypical parakeratosis Other (add comment)
LSIL**	Abnormal cells consistent with condyloma (HPV§ effect)
LSIL	Mild dysplasia/CIN§§ I
HSIL***	Moderate dysplasia/CIN II
HSIL	Severe dysplasia/CIS§§§/CIN III
Carcinoma	Abnormal cells consistent with malignancy
Squamous cell carcinoma	Consistent with invasive squamous carcinoma
Adenocarcinoma	Consistent with adenocarcinoma
Unspecified	Type unspecified
AGUS****
Other Abnormal cells not specifically classified	(Add comment)

1 Adapted from Programmatic Guidelines For Screening For Cancer of the Cervix in Canada⁵¹.
* ASCUS = atypical squamous cells of undetermined significance
** LSIL . low grade squamous intraepithelial lesion
*** HSIL . high grade squamous intraepithelial lesion
**** AGUS . atypical glandular cells of undetermined significance
§ HPV . human papillomavirus
§§ CIN . cervical intraepithelial neoplasia
§§§ CIS . carcinoma in situ

Table B2 : Conversion of Provincial Reporting Categories to the Bethesda Reporting System

Province	Within Normal Limits (WNL) and Benign Cellular Changes (BCC)	Low Grade Abnormalities	High Grade Abnormalities	Carcinoma
British Columbia	Negative, reactive changes (squamous, glandular and epithelial cells)	Atypical, NOS (Not Otherwise Specified), mild (squamous, glandular and epithelial cells)	Moderate, marked and suspicious (squamous, glandular and epithelial cells)	Carcinoma
Ontario	WNL and BCC	ASCUS, LSIL	AGUS, HSIL	Carcinoma
Nova Scotia	Negative	Abnormal, mild dysplasia	Moderate, severe dysplasia	Suggestive and positive for malignancy
Prince Edward Island*	Negative/benign	CIN I	CIN II, CIN III	Carcinoma

^* After 1996, PEI used terminology similar to Ontario

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