A helpful guide to the acronyms being used in our cervical cancer screening cytology reports

In our region, we have patients with high grade dysplasia on pap test results that have not received colposcopy. One of the reasons could be the confusing list of acronyms.

In particular, the high grade acronym – ASC-H that necessitates referral to colposcopy looks very much like one of the low grade acronyms ASCUS.

I reached out to our regional Cervical Screening lead Dr. Andra Nica to provide a quick reference guidance to help us identify patients who are at high risk for cervical dysplasia and cervical cancer, and who need immediate referral to Colposcopy. Here is her very helpful guide.

Understanding cytology (Pap) results in the OCSP:

    1. No intraepithelial lesion or malignancy seen (Normal/NILM)
    2. Low grade results type:
      • Atypical squamous cells of undetermined significance (ASCUS)
      • Low-grade squamous intraepithelial lesion (LSIL)
    3. High grade result types (ACTION REQUIRED – referral to Colposcopy)
      • Atypical squamous cells, cannot rule out high grade (ASC-H)
      • LSIL, cannot exclude HSIL (LSIL-H)
      • High grade squamous intraepithelial lesion (HSIL)
      • Atypical glandular cells (AGC)
      • Atypical glandular cells – favor neoplastic (AGC-N)
      • Atypical glandular cells – favor not otherwise specified (AGC-NOS)
      • Atypical endocervical cells -favor neoplastic (AEC-N)
      • Atypical endocervical cells -favor not otherwise specified (AEC-NOS)
      • Adenocarcinoma in situ (AIS)
      • Adenocarcinoma (ACC)
      • Adenocarcinoma endocervical adenocarcinoma (ACC-E)
      • Squamous cell carcinoma (SCC)

Patients with any of the above-listed high-grade histology (including ASC-H and LSIL-H), and including ANY glandular lesions (atypical glandular or endocervical cells) have an immediate risk of 25% or higher of high grade dysplasia or cancer and must be immediately referred to colposcopy.

Dr. Nica is available on eConsult for any individual patient cervical screening navigation questions you might have!

If you are unsure where to access Colposcopy in your region, we have an updated list and the referral forms (if required) here on our website.

Thank you Dr. Nica