The ASC-US (or ASCUS) smear is an abnormal smear that shows squamous cell abnormalities of unknown significance. Is that bad ? What are the recommendations?
What is an ASC-US smear?
An ASC-US smear is a equivocal cervical smear, on which the cytologist cannot decide. Nearly 10% of smears are ASC-US smears.
What does a positive ASC-US smear mean? Is that bad ?
ASC-US smear highlights a minor change in the squamous cells that cover the cervix. ASC-US is an English acronym meaning ATtypical Squamous VSthey of Undetermined Ssignificanceor in French, Cytological atypia of squamous cells of indeterminate meaning. Doctor Marc Even, obstetrician-gynecologist explains that “these ill-defined cellular atypia are generally difficult to interpret: it may be a normal smear or a smear with mild abnormalities also called low-grade lesions or LSIL“. The abnormalities of the cells do not make it possible to formally exclude a dysplastic lesion or a minor atypia.
A sign of uterine cancer?
Cancer of the uterus is mostly asymptomatic, that is to say without any evocative sign. This is the reason why Pap smear monitoring is fundamental. More rarely, some clinical signs may be observed and should lead the woman to consult her doctor or gynecologist. Any bleeding outside of menstruation or after menopause, or any abnormal discharge should be referred for consultation.
What recommendations in case of ASC-US smear?
Three attitudes are possible in the case of an ASC-US smear:
- First, the doctor may order an HPV test.
- Simple monitoring by cervico-vaginal smear can be offered at 6 months
- A colposcopy can be considered at 6 months
The evolution of an ASC-US smear results in a regression in approximately more than 50% of cases, persistence in approximately 20% of cases and progression to a high-grade lesion in less than 10% of cases.
Thanks to Doctor Marc Even, obstetrician-gynecologist.