Cervical dysplasia refers is abnormal changes in the cells on the surface of the cervix that are seen underneath a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.
The changes are not cancer. However, they can lead to cancer of the cervix if not treated.
Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix
Cervical dysplasia is most often seen in women ages 25 - 35, but can develop at any age.
Most often, cervical dysplasia is caused by the human papilloma virus (HPV). HPV is a common virus that is spread through sexual contact. There are many different types of HPV. Some types lead to cervical dysplasia or cancer.
The following may increase your risk of cervical dysplasia:
There are usually no symptoms.
A pelvic examination is usually normal.
Cervical dysplasia that is seen on a Pap smear is called squamous intraepithelial lesion (SIL). These changes may be:
If a Pap smear shows abnormal cells or cervical dysplasia, you will need further testing:
Dysplasia that is seen on a biopsy of the cervix is called cervical intraepithelial neoplasia (CIN). It is grouped into three categories:
Some strains of human papillomavirus (HPV) are known to cause cervical cancer. An HPV DNA test can identify the high-risk types of HPV linked to such cancer. This may be done:
Treatment depends on the degree of dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment.
Treatment for moderate-to-severe dysplasia or mild dysplasia that does not go away may include:
Rarely, a hysterectomy may be needed. If you have had dysplasia, you will need close follow-up, usually every 3 to 6 months or as recommended by your doctor.
Early diagnosis and prompt treatment will cure nearly all cases of cervical dysplasia. Sometimes, the condition returns.
Without treatment, severe cervical dysplasia may develop invasive cancer. It can take 10 or more years for cervical dysplasia to develop into cancer. The risk of cancer is lower for mild dysplasia.
Call for an appointment with your health care provider if you are age 21 or older and have never had a pelvic examination and Pap smear.
Ask your health care provider about the HPV vaccine. Girls who receive this vaccine before they become sexually active reduce their chance of getting cervical cancer by 70%.
You can reduce your risk of developing cervical dysplasia by taking the following steps:
Cervical cancer in adolescents: screening, evaluation, and manage- ment. Committee Opinion No. 463. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2010;116:469–72.
ACOG Practice Bulletin No. 99: management of abnormal cervical cytology and histology. Obstet Gynecol. 2008;112(6):1419-1444.
Wright TC Jr, Massad LS, Dunton CJ, et al. American Society for Colposcopy and Cervical Pathology-sponsored Consensus Conference: 2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcihnoma in situ. Am J Obstet Gynecol. 2007;197(4):340-345.
Wright TC Jr, Massad LS, Dunton CJ, et al. American Society for Colposcopy and Cervical Pathology-sponsored Consensus Conference: 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol. 2007;197(4):346-355.
Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. N Engl J Med. 2009;361:271-278.
Douglas JM. Papillomavirus. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 381.
Apgar BS, Kittendorf AL, Bettcher CM, Wong J, Kaufman AJ. Update on ASCCP consensus guidelines for abnormal cervical screening: tests andcervical histology. Am Fam Physician. 2009;80:147-155.