What Is ASCUS?
Why Does It Occur? How Is It Managed?

When patients diagnosed with ASC-US are re-evaluated after antibiotics, the final diagnosis most often turns out to be squamous metaplasia and HPV-related lesions. Another approach in patients with ASC-US is HPV DNA typing. In 38% of patients whose biopsy result is CIN 2/CIN 3, the smear result is ASC-US. If patients with an ASC-US result are left untreated, 68.19% return to normal, 7.13% progress to HSIL, and 0.25% turn into cancer. About 83% of patients with an LSIL (CIN 1) result are HPV positive. In 40-55% of patients with LSIL (CIN 1), accompanying HSIL (CIN 2-CIN 3) may be found.

My Result Came Back as ASCUS

Under normal circumstances, we used to first give antibiotic treatment to a patient with an ASCUS result and take another smear after 7-10 days of antibiotic treatment. If that smear result, which also takes 7-10 days, came back as ASCUS again, we would then perform an HPV test. Considering that the HPV test result also takes 12-13 days, this amounts to a stressful process of at best 25 days in total.

For this reason, at SAGA Clinic we prefer to perform the “HPV Test” at an early stage in patients whose smear result is ASCUS, because we do not want our patients to experience prolonged stress. If the HPV test result is negative, we understand that the ASCUS was caused by inflammation or infection in the cervix; we then provide our treatment and are reassured.

If the HPV test result shows a low-risk HPV type such as HPV 6 or HPV 11, we are again reassured; we plan the HPV treatment and call the patient back for a check-up after 1 year.

If the HPV test result shows one of the high-risk HPV types such as HPV 16, HPV 18, HPV 31 or HPV 33, we then move to the next stage and perform colposcopy on the patient.

An ASCUS result does not mean “I have cancer.” However, this result must be taken seriously, an HPV test should be performed, and the necessary further tests should be carried out according to the HPV test result.

ASCUS Management

ASCUS is not a disease but a test result. It is a result that can be a warning sign for other conditions. Therefore, what matters is not treating ASCUS itself but treating the factor that causes ASCUS.