Epithilial Cell Abnormality
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Question:
My question is this: I recently received my Pap smear results and I have an epithelial cell abnormality. I was diagnosed with ASCUS. I was just wondering what this is and whether I should be worried.

Answer:
ASCUS stands for 'atypical squamous cells of undetermined significance'. It's a way for the pathology laboratory to say 'I don't know'.

The vast majority of women with ASCUS don't have cancer or a significant disease, though a few may. A pathology laboratory may assign a Pap smear to the ASCUS category based on changes due to improper drying; blood on the slide; inflammation; or actual changes in the cells themselves, as occur in dysplasia and cancer.

How your doctor will follow you after this depends on many things, such as your risk for cancer (a woman with a history of previous cancer will typically get colposcopy and perhaps a biopsy immediately); whether you've had a previous ASCUS pap; and whether you're pre- or post-menopausal. The higher the risk, the more you need active investigation as mentioned above. Women at low risk will usually be followed by having a repeat pap smear in 3 to 6 months.

Human papilloma virus is associated with cervical cancer. Tests for HPV are being evaluated to help determine how much a woman may be at risk; women with no evidence of having been exposed to HPV may need less aggressive investigation than those who are found to have a sub-type of HPV that's strongly correlated with cancer. Large studies are currently in progress to find if and how HPV testing should be used.

The bottom line is that you need to have this followed up. If you're at high risk for cervical cancer, you need to follow it more closely and perhaps have it checked by colposcopy and biopsy.

By Dr. Flash Gordon

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