The clinical significance of atypical squamous cells of undetermined significance: a laboratory audit of cervical reporting.
OBJECTIVE
To determine the outcomes in women diagnosed with 'Atypical Squamous Cells of Undetermined Significance' (ASCUS) on cervical smears.


METHODS
All diagnoses of ASCUS on cervical smears made at Southern Community Laboratories (SCL) in Christchurch in 1996 were retrieved from the SCL database and correlated with all available previous and subsequent smear and biopsy results from these patients. The outcome was reported as the most significant (highest grade) cervical smear or biopsy over the following two year period.


RESULTS
278 women had smear results of ASCUS in 1996, reflecting 2.3% of total cervical smear diagnoses at SCL (Christchurch) for that period. Follow-up was available for 260 (94%). 61% had benign (normal or inflammatory) changes, 6% had persistent ASCUS (smear only), 18% had a Low Grade Squamous Intraepithelial Lesion (LSIL), and 15% had a High Grade Squamous Intraepithelial Lesion (HSIL). All women with ASCUS who subsequently developed HSIL had persistent abnormal smears.


CONCLUSIONS
An ASCUS smear result indicates a group of women who have an increased risk for detection of HSIL. The effectiveness of routine Pap smears for detection of cervical cytologic abnormality is confirmed.
Roche
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DH
Southern Community Laboratories Ltd, Christchurch. davidr@chch.sclabs.co.nz
Spicer
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N
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology; D003937:Diagnosis, Differential; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*