A Pap test result indicating “atypical squamous cells” is a common finding and typically not a sign of cancer. These results suggest that some cells collected from the cervix appear slightly unusual under a microscope. Atypical squamous cells are the most frequent abnormal finding in Pap tests, affecting approximately 2 million women annually in the United States. This result often requires further evaluation, but it is a starting point for understanding your cervical health, not an immediate cause for alarm.
Understanding Atypical Squamous Cells
Squamous cells are thin, flat cells that form the protective outer layer of the cervix. These cells are routinely collected during a Pap test to screen for cervical changes.
When a Pap test identifies cells as “atypical,” it means they exhibit minor changes in appearance, such as variations in size, shape, or nuclear features, that deviate from normal healthy cells. The term “atypical” indicates these cellular changes are not clearly identifiable as either benign or unequivocally precancerous.
These cells are distinct from clearly precancerous or cancerous cells, which have more pronounced abnormalities. The presence of atypical cells simply flags them for closer attention, prompting further investigation to determine the underlying cause.
Causes and Classifications
Atypical squamous cells can arise from various factors, with human papillomavirus (HPV) infection being the most common cause. HPV is a widespread sexually transmitted infection that can lead to cervical cell changes. Other non-HPV related causes include inflammation, certain infections, benign growths, and hormonal changes.
Atypical squamous cells are primarily categorized into two classifications: Atypical Squamous Cells of Undetermined Significance (ASC-US) and Atypical Squamous Cells, Cannot Exclude High-Grade Squamous Intraepithelial Lesion (ASC-H). ASC-US is the most frequent abnormal Pap test finding, where cells show slight abnormalities, and it remains unclear if these changes are due to an HPV infection or other irritations. This classification suggests a low likelihood of precancerous cells.
In contrast, ASC-H indicates atypical cells with concern for a high-grade squamous intraepithelial lesion (HSIL), representing more significant precancerous changes with a higher potential to progress to cancer if untreated. An ASC-H result carries a greater implication for potential risk compared to ASC-US, necessitating more immediate and thorough follow-up.
Follow-Up and Management
Receiving an atypical squamous cell result typically leads to specific follow-up procedures tailored to the classification. For an ASC-US result, the most common next step is an HPV test to determine if a high-risk type of HPV, linked to cervical cancer, is present. If the HPV test is negative, routine screening may resume.
If the HPV test is positive or if the initial result is ASC-H, a colposcopy is usually recommended. A colposcopy uses a special magnifying instrument to view the cervix, vagina, and vulva. During this examination, the provider may apply a solution to highlight abnormal areas and take small tissue samples, known as biopsies, for further microscopic analysis. Management plans are individualized, taking into account the specific atypical cell classification, HPV status, and other patient-specific factors to determine the most appropriate course of action.
Outlook and Reassurance
The outlook for individuals with atypical squamous cell findings is generally favorable, as these cells rarely indicate cancer. In many instances, particularly with ASC-US, cellular changes resolve on their own without intervention, especially if related to temporary infection or inflammation. Even when high-risk HPV is present, the body’s immune system often clears the virus over time.
Adherence to medical recommendations and attending scheduled follow-up appointments are important for effective management. Regular monitoring ensures persistent or progressive cellular changes are identified early, allowing for timely intervention. By following medical advice, individuals can effectively manage atypical squamous cell findings and maintain cervical health, significantly reducing any potential long-term risks.