What is the recommended follow-up for women aged 21-24 with an ASCUS pap result?

For women aged 21-24 with an ASCUS (Atypical Squamous Cells of Undetermined Significance) Pap result, the recommended follow-up is to perform HPV (Human Papillomavirus) testing. This is based on guidelines that suggest that in this age group, the appropriate management for ASCUS involves assessing for high-risk HPV types.

If HPV testing is performed and the result is negative, the woman can typically return to routine Pap screening at the next interval rather than undergoing additional testing or procedures. If the HPV test is positive, further evaluation such as colposcopy would be warranted to assess for any potential cervical lesions that may need treatment or closer observation.

This approach is part of a strategy to avoid overtreatment and unnecessary procedures for younger women, given the natural history of HPV infection and the high rates of regression in younger populations. By utilizing HPV testing, providers can more accurately manage the follow-up based on the presence or absence of high-risk HPV, which informs the likelihood of cervical neoplasia.

Other options, such as repeat cytology, co-testing, or immediate colposcopy, diverge from these guidelines for this age group and may not provide the best balance of care and psychological reassurance. Thus, HPV testing