What is the most appropriate intervention for a Pap smear showing atypical glandular cells (AGUS)?

The presence of atypical glandular cells (AGUS) on a Pap smear indicates that there may be abnormal changes in the cervical or endometrial cells, suggesting a higher risk for pre-cancerous or cancerous lesions compared to other findings. Therefore, a more definitive evaluation is necessary.

The most appropriate intervention in this scenario is colposcopy and endometrial sampling. Colposcopy allows for direct visualization of the cervix and can help identify areas in need of biopsy. Endometrial sampling is crucial because AGUS cells can originate from the endometrium, and sampling the endometrial tissue can help rule out any endometrial pathology, including hyperplasia or carcinoma.

This combination provides a comprehensive approach to evaluate the source of the atypical cells effectively, ensuring that any potential lesions in both the cervix and endometrium are assessed and managed appropriately.