The ASCUS Pap Smear

ASCUS is the acronym for (atypical squamous cells of undetermined significance). This is the most common abnormal Pap smear test result indicating the presence of cervical cell changes. This term simply means that the squamous cells of the cervix appear unusual and cannot be further categorized. These changes may be due to infections, thinning of the cervix and vagina in women who have low estrogen levels, or precancerous or cancerous changes.

This Pap smear may or may not be due to the presence of Human Papilloma Virus (HPV).

HPV infection is very common. Approximately 70% of women are infected with HPV at some point in their lifetime. The vast majority of the time, the virus causes no problems, and resolves..

This Pap smear, if it also has the presence of HPV, usually triggers the recommendation of a colposcopy. A colposcope is a microscope that provides a closer view of the cervix. The colposcopic exam is similar to a regular pelvic exam and should only take a few minutes to perform. Anesthesia is not required. Dilute acetic acid (vinegar solution) is placed in the vagina to help determine of there are any abnormal areas, they turn white and may be refereed to as aceto-white lesions. The colposcopy itself is painless, however if abnormal areas are seen, then very small (2-3mm) pieces of tissue may be removed in the form of a colposcopically directed biopsy. This may lead to a small about of pain, mild cramping and bleeding which usually rapidly resolves. This cervical tissue is then sent for laboratory evaluation. These biopsies cause no long-term damage to the cervix. Endocervical sampling may also be performed, which is a scraping from the inside of the cervix. This may also lead to mild cramping and spotting.