A pap smear is a gynecological screening that detects cervical cancer by collecting cells from the cervix. The sample is sent to a cytologist who, in case the smear can't be read, will request it to be redone. In the case of a normal smear (no abnormalities noticed) a new test will be done three years later. In case of an abnormal pap smear, a more profound examination will be done by a gynecologist. An ASC-US Pap smear is an equivocal Pap smear, where the cytologist is unable to make a decision. An ASC-US pap smear shows minor cell changes, but the interpretation is difficult. ASC- US is an acronym signifying the existence of atypical cells, but of unknown origin.
Cancer of the uterus is mostly asymptomatic, that is to say without suggestive signs. This is why monitoring by means of a smear is fundamental. More rarely, some clinical signs may be observed and lead the woman to consult her doctor or gynecologist. Any bleeding outside of the menstruation period or after menopause should be questioned.
An ASC-US pap smear indicates a possible change in the cells, but does not allow for a definitive diagnosis. Therefore, it is often accompanied by a virus test or a high-risk HPV test, which can detect the existence of certain strains of HPV. A positive HPV test points to the presence of precancerous cells. This diagnosis is made after:
- a study of the morphology of the cervix, called colposcopy;
- a sample (biopsy);
- one or more MRIs or ultrasounds.
On the other hand, following a test that is negative for HPV, a new smear will be prescribed every 3 years.
Following the completion of the colposcopy and biopsies, and according to their results, typical monitoring will be recommended, or a cone biopsy, where a part of the cervix is removed and analyzed.
Prevention of cervical cancer can be assured by a Pap smear done every 3 years. It is also important to avoid various risk factors, namely unprotected sex, multiple sexual partners and tobacco use. Wearing a condom reduces the risk of contamination, but does not eliminate the risk entirely. Finally, the vaccine against cervical cancer of the uterus is highly recommended for girls 14 to 23 years of age, at the beginning of their sexual lives. Its effectiveness has been recently demonstrated.