Cervical Dysplasia and Cancer

What Changes in Your Cervix Actually Mean

Gynecologist taking smear test
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Cervical cancer is the abnormal and uncontrollable growth of cells that starts in the cervix and can spread to other parts of the body. It a typically slow-progressing disease that often takes years to develop.  

Prior to the development of cancerous cells and tumors, the cervix will undergo abnormal changes called cervical dysplasia which can serve as an early warning sign of a developing malignancy.

Identifying Cervical Dysplasia

Cervical dysplasia is simply defined as abnormal changes in the lining of the cervix. While cervical dysplasia can sometimes lead to cervical cancer, it should by no means be considered a cancer diagnosis.

Cervical dysplasia can be detected by a routine Pap smear with the findings classified as follows:

  • ASCUS (atypical cells of undetermined significance) means that any changes are mildly abnormal. The cause could be a result of anything from an infection to the development of precancerous cells. ASCUS is not an indication of cervical dysplasia until further confirmatory testing is performed.
  • AGUS (atypical glandular cells of undetermined significance) refers to an abnormality in the glandular cells that produce mucus. Although not technically classified as cervical dysplasia, AGUS can be an indication an underlying serious condition. AGUS results are considered rare, occurring in less than one percent of all Pap smear results.

    Alternative Method of Classification

    An alternative method classifies cervical dysplasia by the degree of changes in the cells. This transformation is referred to as cervical intraepithelial neoplasia (CIN). CIN identifies how much of the lining of the cervix is invaded by abnormal cells.

    CIN classifications are broken down as follows:

    • CIN I: mild dysplasia with abnormal cells found in one-third of the lining of the cervix
    • CIN II: moderate dysplasia with abnormal cells found in two-thirds of the lining of the cervix
    • CIN III: severe dysplasia with abnormal cells found in more than two-thirds of the lining of the cervix and up to the full thickness of the lining

    Symptoms and Causes of Cervical Dysplasia

    There are usually no symptoms associated with cervical dysplasia. Most women only find out about it when undergoing a routine Pap smear. 

    In terms of causes, there is a strong link between cervical dysplasia and the human papillomavirus (HPV). HPV is a common virus that most people get with at some stage in their lives. HPV infection is associated with more than 95 percent of all cervical cancer diagnoses, making early detection all the more important.

    An HPV diagnosis does not mean that a woman will get cervical cancer.

    In most cases, HPV will clear up on its own without treatment. Only a handful of HPV strains is associated with the development of cervical malignancies.

    Other risks linked to the development of dysplasia include:

    • smoking
    • having multiple sexual partners
    • pregnancy before the age of 20
    • a compromised immune system, such as in women with HIV

    Treating Cervical Dysplasia

    If a Pap smear finding is abnormal, the next step is to undergo a colposcopy. A colposcopy is an in-office procedure that allows a doctor to examine the cervix more thoroughly. Depending on the findings, a cervical biopsy may be performed.

    Once cervical dysplasia is confirmed, treatment will vary depending severity:

    Sources:

    American Cancer Society Colorectal Cancer Advisory Group. "Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology." Gastroenterology. 2008; 134(5):1570-1595.

    National Cancer Institute. "Cervical Cancer (PDQ®): Screening ." Natural History, Incidence, and Mortality. Washington, D.C.; July 2006.

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