A perimenopausal woman on Pap smear has repoed ASCUS (atypical squamous cell of unknown significance). Next line of management is:
Loop excision
Conization
Colposcopy
Hysterectomy
In Bethesda system, the most common cytological abnormality is atypical squamous cells (ASC). ASC is fuher divided into ASCUS (atypical squamous cell of unknown significance) and ASC-H (atypical squamous cells where HSIL cannot be ruled out). The risk of progression of ASCUS to CIN is 5%. These patients should be followed up with: 1. HPV DNA testing 2. Immediate colposcopy 3. Repeated cytology at 6-12 months Ref: GYANECOLOGICAL DIAGNOSIS ; Novak, 15th edition, page 587q