From the Guidelines
If you have received ASCUS (Atypical Squamous Cells of Undetermined Significance) Pap test results and tested positive for HPV, you should undergo colposcopy as the recommended approach. This is based on the most recent guidelines from the 2019 ASCCP Risk-Based Management Consensus Guidelines Committee, as outlined in the study by Perkins et al. 1. According to these guidelines, for patients with ASC-US or LSIL Pap test results and positive HPV results, colposcopy is the recommended management approach.
Key Considerations
- The presence of HPV, especially high-risk types like HPV 16 and 18, increases the risk of developing cervical abnormalities and cancer.
- Colposcopy allows for the examination of the cervix and the collection of biopsies to identify any abnormal areas that may require further treatment.
- The management approach may vary depending on factors such as age, HPV type, and medical history, but colposcopy is generally recommended for ASC-US and HPV-positive results.
Follow-Up and Prevention
- Regular follow-up is essential to monitor the progression of any cervical abnormalities and to ensure that any necessary treatment is provided in a timely manner.
- Maintaining a healthy immune system through good nutrition, regular exercise, and avoiding smoking can help the body clear the HPV infection naturally.
- It is also important to follow the recommended screening schedule to ensure early detection and treatment of any cervical abnormalities.
Management Guidelines
- The 2019 ASCCP guidelines recommend colposcopy for patients with ASC-US or LSIL Pap test results and positive HPV results, as outlined in the study by Perkins et al. 1.
- The guidelines also emphasize the importance of considering the patient's age, HPV type, and medical history when determining the management approach.
- For patients with HSIL cytology results, expedited treatment may be recommended, while colposcopy is recommended for all other cases, even if the cytology test is normal.
From the Research
AUSCUS Pap Results and HPV Positive
- AUSCUS (Atypical Squamous Cells of Undetermined Significance) Pap test results indicate abnormal cell changes in the cervix, but the changes are not clearly cancerous or precancerous 2.
- HPV (Human Papillomavirus) positive results indicate the presence of high-risk HPV types, which can increase the risk of developing cervical cancer 2.
- Studies have shown that women with AUSCUS or LSIL (Low-grade Squamous Intraepithelial Lesion) Pap smear results have a significant risk of underlying high-grade cervical intraepithelial neoplasia (CIN) or invasive cancer 3.
Management of AUSCUS and HPV Positive Results
- Colposcopy is the accepted diagnostic test for evaluating abnormal Pap test results, including AUSCUS and HPV positive results 4.
- Loop electrosurgical excision procedure (LEEP) is the preferred procedure for advanced diagnosis and treatment of CIN following colposcopy 4.
- HPV triage testing or repeat Pap smear can be used for the management of AUSCUS on Pap smear, but there is evidence of process utility, with immediate HPV testing strategies having lower valuations than repeat Pap smear 5.
- Studies have shown that women with AUSCUS or LSIL Pap smear results should be referred for a colposcopy examination until better triage methods become available 2, 3.
Follow-up and Treatment
- Surveillance options for women with AUSCUS or LSIL Pap test results include continued colposcopy, discharge with Pap testing, or HPV testing at 12 months 6.
- Patients with high-risk results at any point should be treated according to standard of care 6.
- The sensitivity and specificity of different follow-up arms, including colposcopy, Pap testing, and HPV testing, have been evaluated in studies, with varying results 6, 2.