What is cervical dysplasia?
Cervical dysplasia is a condition in which healthy cells in the cervix undergo abnormal changes. The cervix is the lower part of the uterus that goes into the vagina. It is the cervix that dilates during labor to allow the fetus to pass.
In cervical dysplasia, the abnormal cells are not cancerous, but can turn into cancer if not caught and treated early.
According to the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, cervical dysplasia affects 250,000 to 1 million women each year in the United States. It is most common in women between the ages of 25 and 35.
The incidence of HPV decreases with the use of the vaccine. One type of HPV is estimated to have declined by over 60 percent in the young female population in the United States.
What is the cause of cervical dysplasia?
A common virus called human papillomavirus (HPV) causes cervical dysplasia. HPV is a sexually transmitted virus and there are hundreds of strains. Some are low risk and cause genital warts.
Others are high-risk and cause cell changes that can develop into cervical dysplasia and cancer.
Are there risk factors for cervical dysplasia?
There are several risk factors for cervical dysplasia, some of which are directly related to HPV risk:
- have a disease that suppresses the immune system
- using immunosuppressant drugs
- having multiple sexual partners
- giving birth before age 16
- having sex before age 18
- to smoke
If you are sexually active, condoms can reduce your risk of getting HPV. But the virus can still live on the skin surrounding the genitals that is not covered by the condom.
Diagnosis of cervical dysplasia
Typically there are no signs of cervical dysplasia. Occasionally, abnormal bleeding may occur. However, in the absence of symptoms, the cell changes are invisible to the naked eye and are usually found during a regular Pap test.
Pap test results will show a squamous intraepithelial lesion (SIL). This means cellular tissue damage or dysplasia.
There are different categories of SILs, including:
- low grade SIL (LSIL)
- high grade SIL (HSIL)
- probability of cancer
- atypical glandular cells (AGUS)
Most of the time, LSIL goes away on its own. Your doctor may recommend getting a Pap test after a few months to monitor cell changes. If your doctor is worried or you have high-grade changes, a colposcopy may be done.
A colposcopy is an in-house procedure that allows the doctor to view your cervix very closely. A vinegar solution is applied to the cervix and a special light is used. This is any abnormal cell that stands out.
The doctor may then take a small piece of cervical tissue, called a biopsy, to send to the lab for testing. If dysplasia is found on a biopsy, it is classified as cervical intraepithelial neoplasia (CIN).
There are three CIN categories:
- CIN 1, mild dysplasia
- CIN 2, moderate dysplasia
- CIN 3, severe dysplasia or carcinoma in situ
Carcinoma in situ is a cancer that has not spread below the surface layer of tissue.
Treatment of cervical dysplasia
Treatment of cervical dysplasia depends on the severity of the condition. Mild dysplasia may not be treated immediately, as it may resolve without treatment. Repeat Pap smears can be done every three to six months.
Treatment for CIN 2 or 3 may include:
- cryosurgery that freezes abnormal cells
- laser therapy
- loop electrosurgical excision procedure (LEEP), which uses electricity to remove affected tissue
- cone biopsy, in which a cone-shaped piece of cervix is removed from the site of abnormal tissue
Dysplasia is often caught early due to regular Pap tests. Treatment typically cures cervical dysplasia, but it can return. If no treatment is done, dysplasia can worsen, potentially turning into cancer.
Can cervical dysplasias be prevented?
While abstinence is the only surefire way to prevent cervical dysplasia, you can do many things to reduce your risk of getting HPV and cervical dysplasia:
- Use a condom or other protection while having sex.
- If you are between the ages of 11 and 26, consider getting the HPV vaccine.
- Avoid smoking.
- Expect to have sex until you are at least 18 years old.
Talk to your doctor about your sexual activity and steps you can take to reduce your risk of cervical dysplasia.
Cervical lesions (cervical intraepithelial neoplasia, CIN). (Nd). received
Dunne, EF, Unger, ER, Sternberg, M., McQuillan, G., Swan, D., Patel, SS, and Markowitz, LE (2007, Feb. 28). Prevalence of HPV infection among women in the United States. Journal of the American Medical Association (JAMA), 297 (8), 813-819
What is cervical dysplasia? (Nd). received