What kind of attention do each type of cell abnormalities require?

All doctors agree that women who show HSIL cells on their Pap tests should receive a colposcopy and, if necessary, a biopsy. However, there is no agreement among doctors about how to manage women who show ASCUS or LSIL cells. Most doctors either perform immediate colposcopy and, if necessary, biopsy, as for women with high grade lesions. Since low-grade cell changes in many women tend to go back to normal on their own, other doctors choose to wait and repeat the Pap smear every four to six months, then perform colposcopy if the abnormality is still present.

The National Cancer Institute is conducting a study called the ASCUS/LSIL Triage Study to help doctors determine how to best manage these two abnormal cell types in women. So far, results show that it is helpful for women with ASCUS cells to also be tested for HPV to see if their abnormalities need immediate attention. The study found that many women with ASCUS cells who tested positive for HPV had precancer, or rarely, cancer. A negative HPV test provided strong reassurance that precancer or cancer was not present.