 Show When a Pap smear detects atypical squamous cells, follow-up testing is required to determine the underlying cause. In most cases, the presence of abnormal squamous cells does not indicate the presence of cervical cancer. However, abnormal Pap results should always be discussed with a medical professional so that an individualized action plan can be created. Atypical squamous cells can be a sign of:
Usually, when atypical squamous cells are found, the cell sample is re-analyzed to check for the presence of certain viruses, such as HPV. While having HPV does not necessarily mean that a woman will develop cervical cancer, it does increase her risk of developing the condition, which means that more frequent Pap smears may be necessary to detect abnormal changes should they occur. Additional tests, such as cervical biospies, endocervical sampling exams and colposcopies may also be recommended after an atypical Pap result. If cancerous squamous cells are detected during a Pap smear, prompt treatment is advised. The earlier that cancer is detected, the more treatment options a patient typically has. At Moffitt Cancer Center, we offer a comprehensive range of diagnostic tests and treatments that are backed by the latest advances in cervical cancer research. As a National Cancer Institute-designated Comprehensive Cancer Center, we are continually investigating the newest options for preventing, detecting and treating cancer, and our patients directly benefit from our acclaimed clinical trials. Medically reviewed by Jing-Yi Chern, MD, gynecologic oncologist If you’ve recently received abnormal Pap smear results involving the presence of atypical squamous cells, call 1-888-663-3488 or submit a new patient registration form online to request an appointment with one of Moffitt’s gynecologic oncologists. We welcome patients with and without physician referrals. Virtual visits appointments are available, however, in most cases, a complete exam and evaluation in person will be needed to decide the best treatment. by Adnan Karavelic MD FRCPC What does atypical squamous cells of undetermined significance (ASC-US) mean?Atypical squamous cells of undetermined significance (ASC-US) means that abnormal-looking squamous cells were seen on your Pap test. ASC-US is a preliminary result and not a final diagnosis. Conditions associated with ASC-US include non-cancerous changes such as inflammation in the cervix and the pre-cancerous disease low grade squamous intraepithelial lesion (LSIL). The cells in ASC-US are not cancer cells. What causes ASC-US?ASC-US is a relatively common Pap test result in women of all ages. Causes of ASC-US include infection with human papillomavirus (HPV), inflammation of the cervix, postmenopausal status, and prior radiation therapy. What do the cells in ASC-US look like under the microscope?When examined under the microscope, the abnormal squamous cells in ASC-US have larger nuclei and the cytoplasm (body of the cell) is smaller relative to the nucleus compared to the healthy squamous cells normally found in the cervix. Pathologists describe this as an increased nuclear to cytoplasmic ratio. The nuclei can also be slightly darker and have irregular nuclear membranes. Pathologists call cells that look darker than other cells hyperchromatic. What happens after a diagnosis of ASC-US?ASC-US in women under 30 years of ageAccording to the current guidelines, women who are < 30 years of age with ASC-US should have a repeat Pap test in 6 months. If ASC-US is seen again, another Pap test is performed in 6 months. If ASC-US still persists, your doctor should refer you to a specialist who will perform a colposcopy. For women 30 years of age or older with ASC-US, the tissue collected during the Pap test should be sent for human papillomavirus (HPV) testing. This test looks for specific high-risk types of HPV that are known to cause cervical cancer. If a high-risk type of HPV is found in your sample, your doctor should refer you to a specialist who will perform a colposcopy. Finding high-risk HPV does not mean that you have cervical cancer. It does mean, however, that you are at higher risk of developing a pre-cancerous or cancerous growth, and that a closer follow-up with your gynecologist and family physician is required. ColposcopyA colposcopy allows your doctor to see the entire outer surface of the cervix. During the colposcopy, the doctor will be looking for any areas that look abnormal on the surface of the cervix. If an abnormality is found, the doctor may decide to take a small sample of tissue called a biopsy to look for pre-cancerous and cancerous changes. Your doctor may also take a biopsy from the endocervical canal and endometrium. Other helpful resources:Choosing Wisely Canada Cancer Care Ontario What should you do if atypical squamous cells of undetermined significance?ASCUS ~ Atypical squamous cells of undetermined significance
This diagnosis means that some of the cells on your Pap smear did not look entirely normal but did not meet diagnostic criteria for a lesion. Your doctor may either repeat your Pap smear, or perform a colposcopy.
Should I worry about atypical squamous cells of undetermined significance?Atypical squamous cells of undetermined significance (ASC-US) — With ASC-US, the risk of a high-grade precancerous lesion (cells with a moderate to high risk of developing into cervical cancer) is as high as 7 percent, and the risk of cervical cancer is less than 1 percent [1,2].
How long does it take for ASCUS to turn into cancer?Without prompt treatment or close monitoring, about 0.25 percent of women with atypical ASCUS develop cervical cancer within two years.
Can atypical squamous cells go away?They usually go away on their own and do not require treatment. CIN 2 changes are moderate and are typically treated by removing the abnormal cells. However, CIN 2 can sometimes go away on its own. Some people, after consulting with their health care provider, may decide to have a colposcopy with biopsy every 6 months.
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Treatment for atypical squamous cells of undetermined significance
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