This finding differs from large, conventional test series in which ASC-US
test results have been the most-common, abnormal Pap result (36%-39%) preceding CIN 2/3 diagnoses.
In adolescents with ASC-US
and HPV positive or with LSIL, it is now recommended to watch and wait, and repeat the Pap in one year.
With the addition of more-predictive liquid-based Pap tests, the use of 2001 Bethesda terminology, the development of the American Society for Colposcopy and Cervical Pathology guidelines including HPV triage of ASC-US
, and recently, the ability to use imager-guided screening, we sought to investigate the current proportion of ASC-US
Pap tests leading to a high-grade histologic diagnosis.
If cytology at this first year of follow-up of the original ASC-US
or LGSIL is HGSIL or greater, colposcopy should be done.
In these studies, cytology was evaluated with either ASC-US
and above or L-SIL and above being used as the basis for referral after which H-SIL was detected on biopsy.
Although there is significant variability in interinstitutional HPV-positive rates in ASC-US
Pap tests, monitoring the HPV-positive rate in ASC-US
Pap tests is a valuable broad measure of quality.
Test accuracy for detecting CIN2 or higher in patients with ASC-US
8 rates by individual HR-HPV positivity rate in ASC-US
doing Hybrid Capture for HPV DNA on ASC-US
positive Pap tests only.
The performance of p16INK4a immuno-cytochemistry (p16 Cytology) and HPV testing was analyzed on a series of 810 retrospectively collected ASC-US
and LSIL cases.
Atypical Pap test interpretations, such as ASC-US
, ASC-H, and AGC (including endocervical or endometrial glandular abnormalities) are excluded.
Routine HPV DNA testing of residual thin layer preparation samples from women with ASC-US
may well be more cost effective than the traditional management of the past.