ASCUS Pap Smear Results with Positive High Risk HPV: Cervical Treatment Options?

ASCUS HPV PositiveIt’s just scary, isn’t it?

Your doctor just called and said:

“You have ASCUS pap smear results with positive high risk HPV, please come to my office to discuss…”

Anxiety, worry, panic, and fear.

You’re also probably wondering what are the treatment options and next steps.

ASCUS Pap Smear Result: What Does It Mean? Is ASCUS Serious?

Women may have pap smear tests that reveal ASCUS results, and most people are left confused and unsure whether or not they are infected with the risky HPV type that can lead to invasive cancer.

ASC-US stands for “Atypical Squamous Cells of Undetermined Significance”.

ASCUS result means pap test detected cervical cells that do not appear completely normal. ASCUS pap smear results reveal an abnormal test that shows thin and flat squamous cells are growing on the surface of a healthy cervix — but ASCUS denotes the results is inconclusive and unclear whether they are benign or precancerous.

Having understood this mild borderline abnormal results, you do realize that not all changes in cervical cells will cause cervical cancer. Nonetheless, every patient with an ASC-US result requires further tests and monitoring to avoid the increased risk of serious cervical cancer development.

If atypical cells pap smear is associated with HPV test that shows positive results, Colposcopy is required to examine the squamous cells using microscope to check for abnormal changes in the cervix.

Pap Smear Test ResultHPV TestWhat Do These Pap / HPV Test Results MeanRecommended Follow Up As Next Step
ASCUSNegativeNo HPV found, but detected cervical cells that do not appear completely normal.Repeat the Pap and HPV tests in 3 years
ASCUSPositiveHPV found, and detected cervical cells that do not appear completely normal.Colposcopy to examine cervical cells under magnification
Recommended read: Can Positive High Risk HPV Test Results Turns Into HPV Negative?
Noncancerous conditions such as inflammation and infections are usually the most common causes of ASCUS pap results. These causes can lead to changes in cervical cells such that they appear abnormal.

The best thing about the slight changes in the cervical cells can get back to normal after some time.

According to the Association of Reproductive Health Professionals —

75% of women with an ASCUS pap smear results have no abnormal cervical cells.

However, a pap smear test that reveals ASC-US should never be ignored.

Dr. Michael Green gave excellent elaboration on ASCUS pap smear in video below, check it out.


ASCUS With Positive High Risk HPV May Lead To Cervical Cancer

One of the most common infection that can cause ASC-US pap smear result is Human Papillomavirus.

When you take an HPV test, your result can be either HPV negative or HPV positive.

  • If you test negative for HPV, means no HPV has been detected in the cells inside your cervix, and the slight cervical cell changes should not cause panic to you – just need to repeat the pap smear and HPV tests in 3 years time.
  • If you test positive, then the result shows you may have high risk HPV in your cervical cells. ASCUS HPV positive can lead to cervical cells changes, with HPV 16 and 18 are two high risk HPV types that are responsible for 70% of cervical cancers, says the U.S. National Cancer Institute.
Disease / SymptomsHigh Risk HPV Strain Type
Cervical Cancer16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58
Precancerous Changes16, 18, 34, 39, 42, 55
Laryngeal Papillomas6, 11, 30
Throat / Oropharyngeal cancer16
Anal Cancer16, 18, 31, 33, 45, 52, 58
Anal Intraepithelial Neoplasia6, 11, 16, 18, 31, 33, 45, 52, 58
Penile Cancer16, 18

Having ASCUS HPV positive result does not necessarily mean that you have cervical cancer. The changes in the cervical cells can disappear by themselves, and the usual appearance of the cells gets restored with time.

These changes in the cervical cells are usually precancerous, though the high risk type HPV viruses can promote the development of cervical cancer. When detected early, ASCUS pap result will not lead to cervical cancer overnight. According to Medscape:

Although rapid progression is possible, average time from initial HPV infection to manifestation of invasive cervical cancer is estimated at up to 15 years.

When there is evidence of high risk HPV in your body, then close monitoring is highly needed, as ASCUS with high risk HPV positive should not be left to chance and risk cervical cancer development.

ASCUS Treatment Guidelines For HPV Positive and HPV Negative

Most of these cervical cell changes reflected in ASCUS pap results will disappear or get back to normal even without treatment. This is so if the infection with high risk HPV types have not been found in the cervical cells.

Patients with test revealing an ASC-US result are often given estrogen cream which is prescribed by the doctor. Those given this prescription are usually near or past menopause since they tend to experience lower hormone levels. In fact, low hormone levels are associated with ASCUS changes in cervical cells. By applying the estrogen cream on the cervix for a few weeks, the test result is usually reversed and the cells get back to normal.
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On the other hand, if a pap test reveal an ASCUS result with positive high risk HPV, the woman will need follow-up testing with colposcopy. Colposcopy allows the doctor to focus light in the cervix in order to magnify it. When the cervix is well magnified, the doctor can therefore examine the cervix with better vision as well as the vulva and the vagina.

The whole process starts with the doctor using a speculum to open the vagina and then with the help of a cotton swab, apply vinegar solution on the cervix. With the application of vinegar solution, the abnormal cells can be well viewed as they turn white, allowing the doctor to clearly examine them.

If the doctor observes something that does not look normal during colposcopy, cervical biopsy will be performend right after the colposcopy by taking a sample of tissue from the abnormal area for testing and diagnosis. The cervical biopsy results will give the doctor or gynecologist an idea of what steps to take next.

The recommended treatment for ASCUS is actually having a repeat pap smear test after 3 to 6 months. This is so because most of the ASCUS results can be due to an infection or minor causes like irritation or inflammation that can cause some temporary changes to the cervical cells.

Treatment for ASCUS with positive high risk HPV is highly influenced by the results of the colposcopy. They can be treated using the right medical procedures or medications as prescribed by a doctor.


Other Possible Abnormal Pap Smear Causes You Should Know

Vaginal Infection

An ASCUS pap smear result is an abnormal pap test that can indicate that you might be having a vaginal infection. Vaginal infection may come along with some symptoms such as itching and a discharge that has a bad odor. If this infection is detected, your doctor should provide you with a treatment that is aligned to the type of your infection. You will also need follow-up screening and monitoring in order to ensure that you do not have any underlying problems.

Trichomoniasis and other STIs

This is another probable cause of abnormal pap smear results. Trichomoniasis is a sexually transmitted infection that is associated with various symptoms such as vaginal discharge that has a bad odor and vaginal itching. When a pap smear test is done and the disease is discovered, you need antibiotic treatment which can help treat the condition.

>> You Can Test Trichomoniasis and other STI like Chlamydia and Gonorrhea at Home

Recent Engagement in Sexual Intercourse

If you have recently engaged in sexual intercourse, the cells in your cervix can be affected, and can thus give an ASCUS pap smear result. Also, using tampons prior to the test can lead to an ASCUS. The cells in your cervix may have an unusual look, this, however, should not call for great concern.
ASCUS Pap Smear Results Positive High Risk HPVRecommended read: What Can Cause Abnormal ASCUS Pap Smear With HPV Negative?

ASCUS Pap Results With Positive High Risk Cervical HPV: Summary

ASCUS is a term used for reporting the pap smear findings that show some squamous cells or flat cells appear unusual and may or may not be premalignant.

ASCUS HPV positive can occur in women. Some causes of atypical cells pap smear results are not serious but may cause the cervical cells not to appear usual.

When ASCUS pap smear result is found, such results are neither normal nor abnormal, and the doctor may perform an HPV test in order to find out whether there is a high risk HPV in the cervical cells.

Testing positive for high risk HPV requires a follow-up and actions to prevent it from developing into cervical cancer.


1 Comment on "ASCUS Pap Smear Results with Positive High Risk HPV: Cervical Treatment Options?"

  1. Is it possible for ASCUS positive HPV to clear up on its own? Also is it possible to have ASCUS because of recent intercourse?

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