Squamous cell carcinoma is a type of cancer that affects the squamous layers of the epithelium. It’s the most common cancer of the oral cavity. and also is common in the cervix and the skin.
Squamous cells often are involved in abnormal Pap smears, as in a diagnosis of ASCUS (Atypical Squamous Cells of Undetermined Significance),which indicates the presences of unusual cells that are not clearly benign or bad.
When you receive this diagnosis, it means that the squamous epithelial cells found in the cervix have taken on an abnormal morphology, or shape but aren’t necessarily cancerous. In fact, low-grade squamous intraepithelial lesions (LSIL) often heal themselves without intervention.
These lesions are also sometimes known as cervical dysplasias or cervical intraepithelial neoplasia (CIN), High-grade squamous epithelial lesions (HSIL) are more likely to become cervical cancer than LSIL. However, they can also regress.
There are several other Pap smear diagnoses. These include ASC-H, atypical squamous cells, cannot exclude HSIL. As with ASCUS, the meaning of ASC-H is unclear. However, cells diagnosed as ASC-H are more likely to be problematic than those diagnosed as ASCUS.
There is also a Pap smear diagnosis of atypical glandular cells (AGC). This diagnosis refers to changes in the glandular cells in the cervix, which are not part of the squamous epithelium. Changes in the glandular cells generally require more intensive treatment than changes in squamous cells.
Squamous Cells, Cervical Cancer, and HPV
Most cervical cancers and pre-cancers are caused by infections with human papillomavirus (HPV). HPV infects and transforms the squamous cells of the cervix. It can also infect and transform the cells of other tissues in the body.
Depending on circumstances, over time, healthy cells may replace these transformed cells or they may continue growing abnormally and become cancerous.
Other Squamous Cell Cancers and HPV
HPV infection is also associated with squamous cell cancers in other locations. They include cancers of the head and neck, the vulva, the penis, and the anus. In fact, some scientists estimate that four out of every five cancers are caused by HPV.
Fortunately, HPV-associated cancers have been found to be more treatable than other squamous cell cancers — at least in the head and neck.
How do people get HPV-related cancers? For all of the sites mentioned above, HPV transmission is thought to be sexual. Oral, anal and vaginal sex can transmit HPV, but transmission does not require intercourse. Skin-to-skin transmission of HPV is possible.
Treatment
Treating abnormal squamous epithelial cells depends on the Pap smear diagnosis. Though LSILs may normalize on their own, closer follow-up with more frequent pap smears may be necessary.
But when abnormal epithelial cells appear to have a risk of being concerning or cancerous, treatment involves exercising or removing the abnormal tissue. A common excisional method is known as a loop electrosurgical excision procedure (LEEP), where abnormal cells are cut away by a wire loop that’s heated with an electric current.
Urine Test for Epithelial Cells
A urinalysis is a standard test that analyzes the substances in your urine. This includes the amount of epithelial cells your urine contains.
While it’s normal to have small amounts of epithelial cells in your urine, large amounts may signify something is wrong, such as an infection or another medical condition.
What to Expect
A urine sample is needed for an epithelial cells in urine test. You will receive a container where the urine is collected and given instructions on how to take the sample to ensure it does not get contaminated.
Typically, you will not need to fast or do other preparations before taking the test unless instructed by your healthcare provider.
Results
Results of cell amounts are usually reported as approximates, such as “few,” “moderate,” or “many” cells. “Few” cells mean that your epithelial cell numbers are considered to be in the normal range, while “moderate” or “many” cells may be a sign of a medical condition like:
Urinary tract infectionLiver diseaseCancer
Know that having results in the abnormal range doesn’t always mean you have a medical condition. Your healthcare provider will typically order more tests to form a final diagnosis.
A Word From Verywell
It’s understandable that abnormal Pap smear results can seem upsetting. However, remember that many cervical changes go away on their own. This isn’t just true for ASCUS smears. Many pre-cancerous lesions also go away on their own within a year or two.
Therefore, if you have an abnormal Pap smear, talk to your healthcare provider about the steps you want to take going forward. Your healthcare provider may advise treatment. However, they may also take a wait and see approach.
The risk of HPV infection can also be reduced by vaccination. Cervarix and Gardasil are two vaccines that have been shown to reduce the risk of HPV infection. However, they are most effective when they are given before young people become sexually active.
If you are a young adult or the parent of a young adult, talk to your healthcare provider about whether the HPV vaccine is a good option for you. The HPV vaccine is currently recommended as a routine vaccination for young men and women between the ages of 11 and 12. It can be given up until age 26, depending on the circumstances.
