Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital

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dc.contributor.advisorChokoe Maluleke, Mmaphuti Jackie
dc.contributor.advisorIkumi, Nadia
dc.contributor.authorWessels, Raisa
dc.date.accessioned2025-10-02T09:02:01Z
dc.date.available2025-10-02T09:02:01Z
dc.date.issued2025
dc.date.updated2025-10-02T08:35:30Z
dc.description.abstractBackground - Cervical cancer imparts a huge burden on South African women and the healthcare system, making up 17.33% of all cancers in females. Cervical cytology screening, assessed under the Bethesda system, forms an integral part of this effort. Within this system, the Atypical Squamous Cells, cannot exclude High grade squamous intraepithelial lesion (ASC-H) category is said to carry a positive predictive value for High grade Squamous Intraepithelial neoplasia (HSIL) that lies between Atypical Squamous Cells of Uncertain Significance (ASC-US) and HSIL. Aim: The aim of this study was to assess the histological outcome of the ASC-H Papanicolaou smears diagnosed between January 2009 and December 2019 and to compare the yield of high grade histology with the literature. Methods: A computerized search of the Laboratory Information Systems (LIS) at Groote Schuur Hospital yielded 1694 ASC-H cases. Results: Of the 1694 cases identified, 699 cases had data on histology. Of the 699 cases with histology data, the majority of cases showed High Grade Squamous Intraepithelial Lesion (HSIL) on histology (n=271, 38.8%). There were 225 (32.1%) cases of Low grade Squamous Intraepithelial Lesion (LSIL), 75 (10.7%) showed normal histology, 40 (5.7%) cases showed cervicitis, 26 (3.7%) cases showed squamous cell carcinoma, 25 (3.6%) cases were suboptimal for assessment, 21(3.1%) cases showed squamous metaplasia and 16(2.3%) cases reflected diagnoses falling into an “other” category (which includes entities such as benign polyps and glandular lesions). Conclusion: With the larger proportion of cases showing HSIL, the intention of the ASC-H category to identify likely high risk cervical changes and expedite follow-up colposcopy, biopsy and management has been proven.
dc.identifier.apacitationWessels, R. (2025). <i>Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Pathology. Retrieved from http://hdl.handle.net/11427/41970en_ZA
dc.identifier.chicagocitationWessels, Raisa. <i>"Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Pathology, 2025. http://hdl.handle.net/11427/41970en_ZA
dc.identifier.citationWessels, R. 2025. Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital. . University of Cape Town ,Faculty of Health Sciences ,Department of Pathology. http://hdl.handle.net/11427/41970en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Wessels, Raisa AB - Background - Cervical cancer imparts a huge burden on South African women and the healthcare system, making up 17.33% of all cancers in females. Cervical cytology screening, assessed under the Bethesda system, forms an integral part of this effort. Within this system, the Atypical Squamous Cells, cannot exclude High grade squamous intraepithelial lesion (ASC-H) category is said to carry a positive predictive value for High grade Squamous Intraepithelial neoplasia (HSIL) that lies between Atypical Squamous Cells of Uncertain Significance (ASC-US) and HSIL. Aim: The aim of this study was to assess the histological outcome of the ASC-H Papanicolaou smears diagnosed between January 2009 and December 2019 and to compare the yield of high grade histology with the literature. Methods: A computerized search of the Laboratory Information Systems (LIS) at Groote Schuur Hospital yielded 1694 ASC-H cases. Results: Of the 1694 cases identified, 699 cases had data on histology. Of the 699 cases with histology data, the majority of cases showed High Grade Squamous Intraepithelial Lesion (HSIL) on histology (n=271, 38.8%). There were 225 (32.1%) cases of Low grade Squamous Intraepithelial Lesion (LSIL), 75 (10.7%) showed normal histology, 40 (5.7%) cases showed cervicitis, 26 (3.7%) cases showed squamous cell carcinoma, 25 (3.6%) cases were suboptimal for assessment, 21(3.1%) cases showed squamous metaplasia and 16(2.3%) cases reflected diagnoses falling into an “other” category (which includes entities such as benign polyps and glandular lesions). Conclusion: With the larger proportion of cases showing HSIL, the intention of the ASC-H category to identify likely high risk cervical changes and expedite follow-up colposcopy, biopsy and management has been proven. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Cervical cancer KW - Groote Schuur LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital TI - Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital UR - http://hdl.handle.net/11427/41970 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41970
dc.identifier.vancouvercitationWessels R. Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital. []. University of Cape Town ,Faculty of Health Sciences ,Department of Pathology, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41970en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Pathology
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectCervical cancer
dc.subjectGroote Schuur
dc.titleHistological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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