ASCOUS On The Pap
So you get the phone call that your pap smear is abnormal.
That could be pretty distressing, but you have to understand that the pap smear is just a screening test. It helps us decide who needs to get a closer look and who needs to get a shorter interval repeat pap smear. It's just a tool to screen everybody. It's an inexpensive easy way to do screening every year or two, and we'll talk over a long time about the changes in how frequently you get the pap smear. But let's say you get this phone call that your pap smear is abnormal what does it mean? Well understand that when we do a pap smear we are checking to see what the cells look like. And the cells can come back and they could be reported as normal all the way down to cancer and there's categories in between. So first we have normal. It's fantastic. The cells look normal, and you probably won't have to have a pap smear for another couple of years. The next category is called Atypical squamous cells of undetermined significance a-s-c-o-u-s, ACOUS. So atypical cells is the first category right next door to normal. You're almost normal but you're not.
The next category after that is mild and then moderate and then severe dysplasia which means pre-cancer and then you get up to cancer. So you've got normal, atypical squamous cells of undetermined significance, mild, moderate, and severe dysplasia or precancerous, and then cancer. So with the ASCOUS smear back in the day all we did on the pap smear was check the cells. Now what we do, is we also check the status of your HPV. We test for 14 types of high risk HPV - and if you have the atypical squamous cells and you're positive for that HPV virus, we're going to move forward and do something called a colposcopy. And we'll talk about that in another post. But the colposcopy is a way for us to check to see if the pap smear is a false alarm or not. So atypical squamous cells of undetermined significance - first category next to normal. If you're not showing the HPV being positive on your test we're just going to repeat the Pap smear in a year. If HPV is positive we're going to invite you in for a closer look with the Colpus scope and I'll have a post to explain that for you.