Normal: just what you'd like to see

 

Inflammation: could have any number of causes and not a big reason for concern

 

ASCUS: atypical squamous cells of undetermined significance—indicating detection of a few abnormal cells, possibly due to HPV or other infections; not hugely alarming but in need of follow-up

 

LSIL: low-grade squamous intraepithelial lesion; more severe changes in cells than

 

ASCUS; absolutely requires follow-up, although less alarming than HSIL

 

HSIL: high-grade squamous intraepithelial lesion; more severe changes in cells than LSIL; again, follow-up is essential

 

AIN: anal intraepithelial neoplasia; can be graded as: 1, the least serious and similar to

 

LSIL; 2, more serious and akin to HSIL; or 3, the most serious; 2 and 3 indicate localized precancerous changes.

 

Joel Palefsky, MD, and Stephen Goldstone, MD, recommend high-resolution anoscopy for ASCUS, LSIL or HSIL, combined with biopsies of suspicious tissue, the results of which will determine treatment. (For more information on anal Paps, see “Smear Campaign,” POZ, August 1999.)