Brief Answer:
Atypical squamous cell of undetermined significance in papsmear is harmless

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. The pap smear in your case shows cells which are classified as atypical in appearance. These are slightly abnormal cells and not exactly cancer cells.

2. Your doctor is right in adopting the wait and watch method. This is usually recommended for women of your age who have atypical cells in the pap smear.

3. When we talk about abnormal cells in the pap smear, it is from among one of the following groups.

(i) Atypical squamous cells of undetermined significance (ASCUS).
This is usually not a concern and doctors might assess for risk factors such as HPV and if not present then there is no need to worry. Cauterization of the cells usually helps.

(ii) Squamous intraepithelial lesion.
This might be considered as a precancerous condition and is sub classified as low grade or high grade appearance of cells. In low grade, there is risk of cancer after many years. In high grade, there might be a small risk of early cervix cancer and the doctor might suggest additional test like cervical biopsy.

(iii) Atypical glandular cells.
Glandular cells are in the opening of uterus and generate mucus cells. It is unclear if finding atypical glandular cells is precancerous. This also might require additional testing like biopsy.

(iv) Squamous cell cancer or adenocarcinoma cells.
There are highly suspicious or confirmed to be cancer cells and treatment is after confirmation by doing tests.

4. I guess your pap smear shows atypical squamous cells of undetermined significance (ASCUS) and these usually resolve in 3 months. It is unlikely to lead to cancer and therefore your doctor appeared calm. However, it is important to follow up after 3 months when any persisting atypical cells might be cauterized and be treated.

5. Please do not lose your sleep over the pap smear finding of atypical cells and you have an enjoyable married life ahead of you. It is suggested that you take note of the atypical cells and follow up regularly with your doctor. If your mother or sisters or female members of your extended family ever had cervical cancer then please be vigilant about any future development in pap smear findings during the coming years. There is no need to panic.

6. Should you have the following then please consult your doctor before your next appointment.
(i) Bleeding between periods
(ii) Heavy flow during periods
(iii) Discharge from vagina with foul odor
(iv) Unexplained fever or pain in lower abdomen.

7. If required, you doctor might recommend an ultrasound scan pelvis to visualize the uterus and ovaries, at a later date.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Conceiving is not affected by the above condition

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. This condition does not significantly influence the fertility of a woman. At 26 years your fertility is good and is not affected by the presence of atypical cells.

2. In suspicious cancer, there are surgical treatments like cervical conization of the uterus which is done for women showing high grade cells, this might cause preterm labor later during the course of pregnancy. However it does not impact the ability to conceive. Please note this procedure is not required in your case.

3. Hoping that you conceive quickly and your pap smear report gets back to normal the next time.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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