Management of women with atypical squamous cells of undetermined significance (ASCUS)

The objective of this study was to assess strategies using repeated Pap smear, HPV testing, alone or in combination, for identifying women with concomitant Cervical Intraepithelial Neoplasia 2 and 3 (CIN 2/3) among women with Atypical Squamous Cells of Undetermined Significance (ASCUS). We conducted a study among 360 women newly diagnosed with ASCUS who were all referred to colposcopy and underwent a repeat Pap smear and HPV testing using Hybrid Capture (first generation). Nineteen patients were diagnosed with CIN 2/3. Compared to the strategy using abnormal repeated Pap smear alone, strategies using HPV testing reported statistically significant higher specificities and lower proportions of women with ASCUS referred to colposcopy. In particular, a promising strategy would be to refer to colposcopy only women with repeated Pap smear showing CIN and/or those positive for oncogenic HPVs.