I had a Pap smear a week ago that came back showing some atypical cells. My nurse practitioner said I should wait another three or four months and then have another Pap smear. Should I be concerned? Why shouldn't I have another Pap sooner?

--Amy

"Atypical squamous cells of undetermined significance" (ASCUS) is a relatively common Pap smear diagnosis. Basically, it means the cells do not look 100 percent normal, but they are not so abnormal that further investigation needs to be done right away. Most of the time, ASCUS is due to inflammation or "reactive changes," meaning your body's normal response to something (where you were in your cycle when the Pap was done, recent intercourse, tampon use, infection, etc).

If you have not had dysplasia (definitely abnormal cells) before and if the Pap smear did not go on to say "cannot rule out dysplasia," then the consensus is to wait four to six months before repeating a Pap. In most cases, the repeat will be perfectly normal. If you have a history of abnormal Paps, or if this is the second ASCUS Pap in a row, then you should proceed to the next step -- a colposcopy to take a closer look at the cervix and a biopsy of any areas that appear abnormal.

You may want to ask your nurse practitioner about the possibility of having one of the newer Pap smear screens done next time. PAPNET is one new technique in which the traditional Pap smear slide is rescreened by a computer; this increases the detection of abnormalities that the human eye may miss. Another new way of doing Paps is the ThinPrep system: Instead of smearing the specimen on a slide, we swish it in a special vial of fluid; the cells are then filtered and spread on a slide evenly, making it easier to see individual cells. ThinPrep probably decreases the number of ASCUS diagnoses.