What does ascus stand for?
Atypical Squamous Cells of Undetermined Significance (ASCUS) 1 ASCUS. Squamous cells are flat and thin cells that grow on top of a healthy cervix. 2 ASCUS Progression to Cervical Cancer. Without prompt treatment or close monitoring,... 3 False Negatives. Unfortunately, Pap tests have a high percentage of false negative results.
What does ascus mean on a Pap smear?
Atypical Squamous Cells of Undetermined Significance (ASCUS) No woman wants a positive result on a Pap test. A positive result means further testing may be needed, and there is the possibility that those tests could result in a cervical cancer diagnosis.
What is ASC-US diagnosis in cervical cancer?
An ASC-US diagnosis may mean NILM or true precancer and hence poses a management challenge, which needs to be addressed by triaging with molecular testing and histology. VIA (visual inspection with acetic acid), together with same-day treatment, has been shown to reduce the incidence of invasive cervical cancers.
What is the prognosis of atypical squamous cells of undetermined significance (ascus)?
ASCUS Progression to Cervical Cancer. Without prompt treatment or close monitoring, about 0.25 percent of women with atypical squamous cells of undetermined significance (ASCUS) develop cervical cancer within two years. Of course, that means that more than 99 percent of women do not develop cervical cancer within that timeframe,...
What percentage of ASCUS is cancer?
The 2-year cumulative risk of cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) within the ASCUS population was reported to be 8%–9% based on a single ASCUS interpretation in the ALTS [10].
Can you have cancer with ASCUS?
While only a small percentage of women with ASCUS develop cervical cancer, roughly half of all cases of CIN-2 and CIN-3—abnormal cells that may eventually become cervical cancer—are found in women with ASCUS.
Does ASCUS mean pre cancer?
ASCUS is a very common Pap test abnormality and often means that there is no actual disease. However, ASCUS Pap results could be an early warning of a pre-cancer change (dysplasia) or cervical cancer, and should always be followed up.
What happens if you have ASCUS?
ASCUS stands for atypical squamous cells of undetermined significance' and means your test results are abnormal. An abnormal result indicates there are some cells in your cervix that are not 'normal' and need to be checked for possible HPV.
Should I be worried about ASCUS?
If abnormal cells persist or the condition worsens, referral to specialist clinic for colposcopy will be required. Since the progression from severe deterioration of cervical cells to cancer generally takes about 5 to 10 years, the condition does not pose any immediate threat, please do not worry excessively.
Should I worry about atypical squamous cells?
Atypical squamous cells of undetermined significance (ASC-US)—ASC-US means that changes in the cervical cells have been found. The changes are almost always a sign of an HPV infection. The changes may also be a result of infection or inflammation. ASC-US is the most common abnormal Pap test result.
What causes ASCUS besides HPV?
It may be a sign of infection with certain types of human papillomavirus (HPV) or other types of infection, such as a yeast infection. It may also be a sign of inflammation, low hormone levels (in menopausal women), or a benign (not cancer) growth, such as a cyst or polyp.
How is ASCUS treated?
ASCUS treatment includes repeated cytology, HPV typization and colposcopy. Protocol of monitoring depended on the result of repeated PAP test.
When do you repeat Pap smear with ASCUS?
HPV testing (high risk types) is the preferred method for triage of ASCUS results using liquid cytology for ages 25-65. If 21-24 years, repeat PAP in 12 months. Screening practice should not change on the basis of HPV vaccination.
How do you get ascus?
ASCUS may be caused by a vaginal infection or an infection with a virus called HPV (human papillomavirus, or wart virus). Your doctor will talk with you about the options of looking at your cervix with a microscope (colposcopy) or repeating your Pap smear every six months for two years.
Are atypical squamous cells cancerous?
A finding of abnormal cells in a Pap test. It means there are abnormal squamous cells in the tissue that lines the outer part of the cervix. Atypical squamous cells, cannot exclude a high-grade lesion may be a sign of a high-grade squamous intraepithelial lesion (HSIL), which may become cervical cancer if untreated.
What is worse ascus or LSIL?
This means your Pap smear results are borderline, between normal and abnormal. ASC-H (Atypical squamous cells of undetermined significance-cannot exclude HSIL). This means your Pap smear results are borderline but may be more serious. LSIL (Low grade squamous intraepithelial lesion).
Does ASCUS and HPV mean cancer?
It may be a sign of infection with certain types of human papillomavirus (HPV) or other types of infection, such as a yeast infection. It may also be a sign of inflammation, low hormone levels (in menopausal women), or a benign (not cancer) growth, such as a cyst or polyp.
Can atypical squamous cells be cancer?
A finding of abnormal cells in a Pap test. It means there are abnormal squamous cells in the tissue that lines the outer part of the cervix. Atypical squamous cells, cannot exclude a high-grade lesion may be a sign of a high-grade squamous intraepithelial lesion (HSIL), which may become cervical cancer if untreated.
What were your first signs of cervical cancer?
SymptomsVaginal bleeding after intercourse, between periods or after menopause.Watery, bloody vaginal discharge that may be heavy and have a foul odor.Pelvic pain or pain during intercourse.
Can an ultrasound detect cervical cancer?
For locally advanced cervical cancer, 3-dimensional transvaginal ultrasound (3D-TVUS) was used to diagnose the extent of invasive cervical cancer and compare to that of Magnetic resonance imaging 26.
What is the significance of ASC US?
The diagnosis of ASC-US begins to gain clinical significance when it is associated with a positive hrHPV diagnosis. Both reflex HPV DNA testing and co-testing have reported a high incidence of hrHPV in ASC-US specimens. [60][34] The 'U' in ASC-US stands for 'undetermined' significance because it is unclear how much of the ASC-US may resolve to become negative and how much would persist and progress to become low- or high-grade squamous intraepithelial lesion.[68] Also, the main factors responsible for persistence are not fully understood, though hrHPV infection is known to persist more in HIV positive patients compared to HIV negative patients, resulting in a higher incidence of invasive cervical cancer in HIV positive patients. [69][25]
What is ASC US?
ASC-US is a cytopathology term that implies cervical epithelial cell abnormalities described by the Bethesda system for reporting cervical cytology. It refers to abnormal cytologic changes that are suggestive of SIL but are qualitatively and quantitatively less than those of a definitive SIL diagnosis.[1] The morphologic criteria of ASC-US include cells that have the shape and size of superficial or intermediate squamous cells with enlarged nuclei 2.5 to 3 times the area of those of normal intermediate squamous cells, slightly increased nucleo-cytoplasmic ratio, with minimum hyperchromatism and irregular chromatin. The cytoplasm may show halo and atypical parakeratosis (dense orangeophilic). These criteria may vary slightly among different laboratories due to differences in slide preparation and staining techniques. [52][53][54] The distinction between a true premalignant lesion and a neoplastic one is based on the number, type, and severity of change both in the nucleus and cytoplasm. An ASC-US smear may also show mitosis, blurring of cytoplasmic borders, binucleation, and corneal pearls. Other histologic changes include squamous epithelial giant cells and parakeratosis.[55] Hyperchromasia and enlargement of nucleoli suggest a progression from a ‘mere’ ASC-US to LSIL/CIN 1 plus. [56][57] Histologically and as described earlier, the CIN histological classification is a three-tier grading of CIN that corresponds to the number of layers of epithelial cells affected by atypia.
What are atypical squamous cells?
Atypical squamous cells that are related to an underlying SIL are associated with HPV infection. Following the initial acquisition of hrHPV, there is an inflammatory response that resolves after a short time. The chronic cases progress to more severe persistent infection associated with nuclear and cytoplasmic changes. In the presence of hrHPV 16 and 18, the viral genes E6 and E7 are thought to encode viral proteins in the infected squamous cells that promote the degradation of tumor suppressor gene proteins p53 and Rb respectively, resulting in malignant transformation. [26][47] Mahira Jahic and Elmir Jahic did a prospective analysis of 1,784 Pap smears and found that, out of 254 abnormal smears, overall, 74% persisted, 8% regressed, and 18% progressed to the worse stage.[46] Studies using immunohistochemistry have associated the loss of certain capsid proteins in ASC-US specimens with progression to a more severe form of precancer. Eun Young Ki and colleagues showed that detection of HPV serotypes 16 and 18 in the absence of HPV L1 capsid expression predicted worsening of precancer.[48] HIV positivity has also been known to promote HPV persistence and associated with a higher incidence of ASC-US. [25][49] Furthermore, a low CD4 count and not being on antiretroviral therapy were associated with the persistence of HPV infection. [50][49][31][51][46][47][12]
How prevalent is HRHPV in ASC US?
Other studies have demonstrated a high prevalence of hrHPV in patients with ASC-US; one study in Brazil analyzed 1,340 liquid-based cytology specimens and found out that 64% of ASC-US specimens harbored hrHPV.[31] In two separate studies, Mai Nishimura reported identifying hrHPV in 81 % of patients with ASC-US. In contrast, Ming Guo and colleagues reported a hrHPV 16/18 incidence rate of 37% in their ASC-US patient cohort, while one Mexican study found an incidence rate of 11.2 percent. [32][33][34] In another study in Turkey, 129 women with abnormal Pap smears were screened for hrHPV positivity, 94 had ASC-US diagnosis, and 94% of those had a hrHPV. [35]
Is cervical cancer a sexually transmitted disease?
Cervical cancer is not a sexually transmitted infection, but it develops from precursor lesions (CIN) that are predisposed by a persistent infection with a common sexually transmitted pathogen, the HPV. There are over 200 species of human papillomavirus. Researchers have identified 13 hrHPV viral strains that cause human cancers, of which HPV 16 and HPV 18 cause about 70 percent of cervical cancers, and more so in HIV-infected women. [29][30] The atypical squamous cells seen in cervical cytology may be related to HPV infection and neoplasia. They are just cytologic mimics caused by inflammation, air drying, atrophy with degeneration, and other artifacts. One study of the U.S. cervical screening programs showed about 50% of women with atypical squamous cells are infected with HrHPV. In contrast, the other noninfected women are not at increased cancer risk. [2]