[ASCUS: an update]

Area of Science:

• Gynecologic pathology
• Cervical cytology
• Cytopathology reporting systems

Context:

• Atypical squamous cells of undetermined significance (ASCUS) in cervical cytology presents diagnostic challenges for clinicians.
• The histological correlation for ASCUS ranges from normal cervical mucosa to invasive carcinoma, often stemming from benign reactive changes.
• The Bethesda System for Reporting Cervical Cytology has evolved, with ASCUS subcategorized into ASC-US and ASC-H in 2001.

Purpose:

• To provide updated clinical management guidelines for ASC-US and ASC-H diagnoses.
• To clarify the diagnostic spectrum and implications of ASCUS findings.
• To improve the link between cervical cytology reporting and lesional diagnosis.

Summary:

• ASCUS diagnoses require careful management due to their broad differential diagnosis.
• The subcategorization of ASC into ASC-US (atypical squamous cells of undetermined significance) and ASC-H (atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion) aims to refine diagnostic accuracy.
• This review synthesizes current knowledge to guide clinicians in managing these specific cytological findings.

Impact:

• Facilitates more precise patient management based on ASCUS subcategorization.
• Aims to reduce unnecessary procedures for benign conditions while ensuring timely diagnosis of significant lesions.
• Contributes to the standardization of cervical cancer screening protocols.