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Original ArticleOpen Access
Women in a Region with High Incidence of Cervical Cancer Warrant Immediate Colposcopy for Atypical Squamous Cells of Undetermined Significance on Cervical Cytology
Suntornlimsiri W 
Objective: To evaluate the histopathology of women who had “atypical squamous cells of undetermined significance” (ASC-US)
on cervical cytology in a region with high incidence of cervical cancer.
Material and Method: Retrospective case-record review of 254 women with ASC-US cytology undergoing colposcopic
examination at Nakornping Hospital between October 2003 and September 2007.
Results: Of the 254 patients who had ASC-US smears underwent colposcopic and histopathologic evaluation. The mean age
was 45.3 years (range,18-72 years). The histologic diagnoses, obtained from colposcopically directed biopsy or endocervical
curettage or loop electrosurgical excision procedure or cold knife conization after initial colposcopy, showed that 47 (18.5%)
women had histologically confirmed high-grade lesions and 20 (7.9%) women had invasive cancers. There was no statistically
significant difference in the incidence of high-grade or invasive lesions between who were 50 years old or more and those who
were younger (50.0% and 50.5%, respectively, p = 0.39).
Conclusion: Reporting ASC-US cytology in our population is obviously associated with significant cervical pathology,
particularly invasive cancer that is possible at a rate higher than previously reported. Women who have ASC-US smears
should therefore be referred for immediate colposcopy regardless of age.
Keywords: Atypical squamous cells of undetermined significance (ASC-US), Cervical cytology, Colposcopy
on cervical cytology in a region with high incidence of cervical cancer.
Material and Method: Retrospective case-record review of 254 women with ASC-US cytology undergoing colposcopic
examination at Nakornping Hospital between October 2003 and September 2007.
Results: Of the 254 patients who had ASC-US smears underwent colposcopic and histopathologic evaluation. The mean age
was 45.3 years (range,18-72 years). The histologic diagnoses, obtained from colposcopically directed biopsy or endocervical
curettage or loop electrosurgical excision procedure or cold knife conization after initial colposcopy, showed that 47 (18.5%)
women had histologically confirmed high-grade lesions and 20 (7.9%) women had invasive cancers. There was no statistically
significant difference in the incidence of high-grade or invasive lesions between who were 50 years old or more and those who
were younger (50.0% and 50.5%, respectively, p = 0.39).
Conclusion: Reporting ASC-US cytology in our population is obviously associated with significant cervical pathology,
particularly invasive cancer that is possible at a rate higher than previously reported. Women who have ASC-US smears
should therefore be referred for immediate colposcopy regardless of age.
Keywords: Atypical squamous cells of undetermined significance (ASC-US), Cervical cytology, Colposcopy
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