A is the correct answer

Current guidelines for abnormal cervical cancer screening results recommend equal management for equal risk. Consequently, colposcopy, treatment, or surveillance is based on a patient’s immediate risk of cervical intraepithelial neoplasia grade 3 or worse (CIN 3+), which is determined by a combination of current results and past history. Atypical squamous cells of undetermined significance (ASC-US) are cells with abnormalities that do not show a squamous intraepithelial lesion. Patients with ASC-US who have a positive human papillomavirus (HPV) cotest and unknown previous history of HPV have an immediate risk of CIN 3+ equal to 4.45%. This exceeds the > 4% threshold recommended for management with colposcopy in women who are age ≥ 25.

Proceeding with a loop electrical excision procedure (B) would be too aggressive for a patient with this level of CIN 3+ risk. The threshold when treatment should be considered is > 25%. Repeat HPV-based testing in 3 years (C) would be appropriate management had the patient’s risk been 0.15–0.55%. Repeat Pap smear in 12 months (D) is recommended when HPV-based testing is not available.