Atypical Squamous Cells of Undetermined Significance(ASCUS) High risk HPV test performed

When the cervical screening test shows the presence of ASCUS, it means that the cells are somewhat different from normal cells under the microscope but their degree of deterioration is not severe enough for them to be called pre-cancerous cells. ASCUS is the most common abnormal finding in cervical screening tests: Out of every 100 women taking the screening test, about 3 to 5 will have the above manifestation and 50% of whom will have their cells regressed to normal after 4 to 6 months. HPV triage is an additional test that has been performed to assess whether the cervical cells have been infected by high risk Human Papilloma Virus (HPV) or not. This further assesses the risk of cells changing to pre-cancerous or cancerous cells over time because nearly all cases of cervical cancer are caused by infection with high risk HPV.

If the cervical cells have not been infected by high risk HPV, the chance of severe cell deterioration is very low.  Therefore, women will only be required to repeat the test 3 years later.  If the result of the repeat test is normal, then she can continue routine screening like other women. If the result of the repeat test shows persistent abnormal cells, or cells with further deterioration, then she will be referred to specialist clinic for colposcopy. 

We understand that women may wish to have a repeat test as soon as possible. As the external layer of cervical cells has been scraped off during the previous smear and the cells take time to grow again (at least 4 to 6 weeks), early re-examination cannot reflect the condition of the cervical cells accurately and would not allow the cells sufficient time to regress to normal. Moreover, overly frequent testing could detect changes that may never cause cancer, thereby leading to unnecessary anxiety, investigations and treatment. It is therefore advised that you attend for a repeat test at the scheduled time.

If the cervical cells have been infected by high risk Human Papilloma Virus, there is a chance that these cells may have severely deteriorated or have even developed into cancer. Therefore, the women must be referred to specialist clinic for colposcopy.  Since the progression from severe deterioration of cervical cells to cancer generally takes 5 to 10 years, the condition does not pose any immediate threat, so please do not worry excessively.

What is colposcopy?

Colposcopy refers to the examination of the vagina using a magnifying glass. The examination procedure can be performed at clinics without anaesthesia and will take about 10 minutes.

Procedures

The doctor will insert the colposcope, stain the vagina and cervix with special medicinal solution and then use the magnifying glass to identify any abnormal lesion.  If abnormal lesion is found, the doctor will use an equipment to extract a small piece of the tissue and send it to the laboratory for further analysis.  The whole process is painless and therefore there is no need to worry about the procedure.

(Content revised 03/2017)