Atypical squamous cells are a common finding during a Pap test, a routine screening for cervical changes. These cells show some alterations but are not clearly precancerous or cancerous. While such a result often indicates a need for further evaluation, it typically does not signify a serious condition. Additional investigation is prompted to determine the underlying cause.
Understanding Squamous Cells
Squamous cells are thin, flat cells that form the surface lining of various organs, including the cervix. In the cervix, these cells continuously shed and are replaced, playing a protective role. A Pap test collects these cells to examine them under a microscope for any abnormal changes.
When a Pap test reveals “atypical” squamous cells, it means the cells exhibit unusual features that deviate from their normal appearance. These cellular changes are not distinct enough to be classified as low-grade or high-grade precancerous lesions. The term “atypical” describes cells that are neither definitively normal nor clearly abnormal.
These cellular alterations can arise from various non-cancerous factors, such as inflammation, infection, or irritation of the cervix. Common causes include yeast infections, bacterial vaginosis, or changes related to menopause. The atypical appearance might also be linked to human papillomavirus (HPV) infection.
Interpreting an Atypical Result
An atypical squamous cell result from a Pap test is not a diagnosis of cancer. It indicates that some cells collected from the cervix show minor changes, suggesting a need for further investigation. The interpretation often depends on specific classifications used by pathologists.
The most common classification is Atypical Squamous Cells of Undetermined Significance (ASC-US). This category signifies that the cellular changes are too subtle to definitively determine their cause or significance. ASC-US results are often associated with benign conditions, such as inflammation or temporary cellular reactions, and a significant percentage resolve on their own.
Another classification, less common but more concerning, is Atypical Squamous Cells, cannot exclude High-grade Squamous Intraepithelial Lesion (ASC-H). This result indicates that while the cells are atypical, their appearance raises a suspicion of a more significant underlying precancerous change. ASC-H results warrant a more immediate and thorough follow-up due to the potential for high-grade lesions.
Atypical squamous cells are not cancer. They represent a spectrum of cellular changes, most of which are not cancerous and often resolve without intervention. They serve as a signal for healthcare providers to conduct additional tests to rule out any progression towards precancerous conditions.
Next Steps After an Atypical Result
Following an atypical Pap test result, the specific next steps depend on the classification of the atypical cells and individual patient factors. One common recommendation is a human papillomavirus (HPV) test, if not already performed. HPV testing helps determine if high-risk strains of the virus, which can cause cervical changes, are present.
For an ASC-US result, options often include repeating the Pap test in six to twelve months, or performing an HPV test. If the HPV test is negative, routine screening can resume. If the HPV test is positive, or if a repeat Pap test still shows atypical cells, a colposcopy may be recommended.
In cases of ASC-H, a colposcopy is the next recommended step due to the higher suspicion of a significant lesion. During a colposcopy, a healthcare provider uses a magnifying instrument to examine the cervix more closely. Biopsies, which involve taking small tissue samples, may be performed during this procedure to provide a definitive diagnosis.
These follow-up procedures aim to identify the cause of the atypical cells and to rule out or diagnose any precancerous conditions. The approach is tailored to each individual, considering their medical history and the specific findings of the Pap test.