Should I be worried about squamous epithelial cells?

October 2, 2025 •

3 min read

According to health data, the presence of some squamous epithelial cells in a urine sample is a very common finding, and often, it is nothing to be concerned about. Whether you should be worried about squamous epithelial cells depends entirely on the context and the specific lab test result.

Quick Summary

The significance of squamous epithelial cells depends on the lab test and quantity found. In urine, a few cells are normal, but many can indicate contamination or, less commonly, infection or irritation. In a Pap smear, abnormal squamous cells require further investigation, but are often not cancer.

Key Points

Normal shedding: Finding a few squamous epithelial cells in a urine sample is a normal part of the body's cell turnover and is generally not a health concern.
Sample contamination is common: The most frequent reason for elevated squamous cells in a urine test is contamination from the skin or genital area during an improper collection. A simple retest with a clean-catch method often resolves this.
UTI or irritation: A high count of squamous epithelial cells in urine, especially accompanied by other abnormal markers like white blood cells, can signal a urinary tract infection or irritation.
Pap smear abnormalities: In a Pap smear, abnormal squamous cells (like ASC-US, LSIL, or HSIL) require further investigation, often due to HPV infection, and can indicate precancerous changes.
Context is key: The worry level associated with squamous epithelial cells depends on the specific lab test (urine vs. Pap smear), the quantity of cells found, and the presence of other symptoms or abnormal test results. Always discuss findings with a doctor.
Follow-up is crucial: For both urine and Pap test results, the next steps depend on the specific findings. This may range from a simple repeat test to more detailed follow-up procedures like a colposcopy or biopsy.

Understanding squamous epithelial cells

Squamous epithelial cells are flat, scale-like cells that form a protective barrier on many surfaces of your body, both inside and out. They are constantly shed as part of your body's normal cellular turnover. You can find them in your skin, the lining of your mouth, the outer urethra, and the cervix. The importance of finding these cells lies in where they are found and how many there are.

Squamous epithelial cells in urine

For many, the question of "Should I be worried about squamous epithelial cells?" arises after a routine urinalysis. In this context, the presence of these cells is a frequent, and often benign, occurrence.

Causes of squamous cells in urine

The most common reason for a moderate or high number of squamous epithelial cells in a urine sample is contamination from the outer skin and genitals during collection, especially with improper cleaning. Normal shedding also contributes to a few cells being present, which is considered normal. A significant number alongside other infection markers like white blood cells or bacteria may indicate a UTI or inflammation. Less commonly, conditions affecting the kidneys or bladder can increase shedding.

What to do about a urine test result

If your urinalysis shows elevated squamous epithelial cells, especially with symptoms, your doctor might recommend a retest using a proper clean-catch midstream sample to reduce contamination.

Squamous epithelial cells in a Pap smear

In a gynecological examination, squamous epithelial cells from the cervix are checked for abnormalities. This differs significantly from a urine test and requires careful interpretation.

Interpreting Pap smear results

Atypical Squamous Cells of Undetermined Significance (ASC-US) means cells are unusual but not clearly abnormal, often requiring further testing for causes like inflammation or HPV. Low-Grade Squamous Intraepithelial Lesion (LSIL) shows slightly abnormal, often HPV-related cells that frequently resolve but need monitoring. High-Grade Squamous Intraepithelial Lesion (HSIL) involves more significant changes likely to become cancerous if untreated, requiring immediate specialist follow-up. Squamous Cell Carcinoma, though rare, indicates cervical cancer.

Comparing squamous cell findings

Understanding the context is crucial. What's normal in one test can be significant in another.


Feature	Squamous Epithelial Cells in Urine	Squamous Epithelial Cells in a Pap Smear
Primary Meaning	Most often indicates sample contamination. Can signal infection if other markers are present.	Evaluates the health of cervical cells for abnormalities, dysplasia, or cancer.
Significance of High Count	Commonly means contamination. High numbers can also point to infection or irritation.	Indicates cellular changes, ranging from minor abnormalities to precancerous or cancerous conditions.
Associated Causes	Improper sample collection, normal shedding, UTIs, kidney stones.	HPV infection, cellular inflammation, pre-cancer, or cancer.
Next Steps	Often a repeat test using a "clean catch" method, possibly a urine culture.	Follow-up testing like an HPV test, colposcopy, or biopsy, depending on the severity.

When to be concerned and what to do next

For any lab result, discussing findings with your healthcare provider is crucial for interpretation based on your health and history.

If your urine test shows an elevated count

Check for symptoms like pain or frequent urination, which could indicate a UTI and need treatment. If asymptomatic, your doctor will likely recommend a repeat clean-catch urine test. If high counts persist or infection signs are present, a urine culture may be ordered.

If your Pap smear shows abnormal cells

An abnormal Pap smear doesn't automatically mean cancer; many abnormalities are temporary and manageable. Follow your doctor's plan, which may involve further testing or monitoring. Discuss HPV testing as it's a common cause of changes.

The takeaway: Context is everything

While finding "squamous epithelial cells" on a lab report might sound concerning, it's a common result with varied meanings. In urine tests, it often indicates a collection issue, while in a Pap smear, it's a key diagnostic indicator needing follow-up. Your healthcare provider is the best resource for accurate interpretation and next steps.

For more detailed information on understanding lab results, consult reputable health organizations such as MedlinePlus.

Conclusion

Finding squamous epithelial cells on a lab report isn't usually an immediate cause for concern but requires attention. Their significance varies greatly depending on the test. In urine, high numbers often point to contamination, whereas in a Pap smear, they can signal cellular changes needing medical follow-up. Working with your doctor helps determine the meaning of your results and guides appropriate action.

Frequently Asked Questions

Having a few squamous epithelial cells in your urine is a normal and very common finding. These cells are naturally shed from the lining of the urinary tract and surrounding areas, so their presence in low numbers is not a cause for concern.

The most common cause for a high count of squamous epithelial cells is contamination of the sample with cells from the skin or genitals during collection. Less commonly, it could indicate a urinary tract infection (UTI), inflammation, or another underlying medical condition.

In a urine test, squamous cells are primarily evaluated to see if there is contamination or infection in the urinary tract. In a Pap smear, the focus is on identifying any abnormal changes in the squamous cells of the cervix that could be precancerous or cancerous.

The "clean catch" method is a specific procedure for collecting a urine sample that is designed to minimize contamination. If your test shows a high number of squamous cells, your doctor may ask you to repeat the test with a proper clean catch to rule out contamination as the cause.

In urine, the presence of squamous epithelial cells alone does not indicate cancer. In a Pap smear, however, abnormal squamous cells can be a sign of precancerous or cancerous changes, particularly related to HPV infection.

For a urine test, you should see a doctor if you have a high cell count combined with symptoms like burning or pain during urination. For a Pap smear, any abnormal result involving squamous cells should be discussed with your doctor to determine the appropriate follow-up plan.

Yes, HPV is a common cause of abnormal squamous cell findings on a Pap smear. Certain high-risk strains of HPV can lead to cellular changes that may become precancerous over time.