Gynecological cytology cascade

Gynecologic cytology, also known as PAP or liquid-based cytology, is the microscopic examination of a cervical specimen to detect cancer or lesions that may develop into cervical cancer. Negative results are those indicating "negative", "no malignancy" or "no intraepithelial lesions". Incidental comments indicating inflammatory changes, atrophic vaginitis, or "consistent with repair," "no significant atypia," or equivalent are not associated with the risk of developing cervical cancer.

With the exception of results identified as ASC-US (atypical squamous cells of unknown significance), other lesions are usually followed by colposcopy to clarify the nature of the lesion. Findings identified as ASC-US indicate the mildest stage of abnormality and if not repeated do not require colposcopy. In women over 21 years of age, a significant abnormality on the PAP test should be automatically performed (gynecologic cytology cascade).

ASC-H (atypical cells not ruling out a high-grade lesion), LSIL (low-grade intraepithelial lesions) and HSIL (high-grade intraepithelial lesions) are more serious to be confirmed on colposcopy. The diagnosis of invasive squamous cell carcinoma indicates that cervical cancer is present. Atypical glandular cells are also important, as they may eventually become cancerous.