What is the best approach for patients with ASCUS detected on Pap smear?
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DNA testing for human papillomavirus (HPV), especially if the sample can be obtained at the same time as the Papanicolaou (Pap) smear, can guide the management of women whose test result shows atypical squamous cells of undetermined significance (ASCUS). Those who test positive for high-risk types of HPV should be referred for colposcopy (strength of recommendation [SOR]: B), and those with a negative test result may resume regular Pap testing in 12 months (SOR: B). If HPV testing is unavailable, an alternative strategy is to repeat the Pap smear at 4- to 6-month intervals. After 2 negative Pap smears are obtained, usual screening may resume. But if either of the repeat Pap smears results in ASCUS or worse, the woman should be referred for colposcopy (SOR: B).
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