Cervical Dysplasia and Cancer

What You Need to Know About Cervical Dysplasia and Cancer

Gynecologist taking smear test
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In most cases, cervical cancer is a slow-progressing disease that often takes years to develop. Before actually developing into cancer, the cervix undergoes abnormal changes called cervical dysplasia.

What is Cervical Dysplasia?

Cervical dysplasia describes the mild to severe abnormal changes that can occur in the lining of the cervix. It is detected by a routine Pap smear. Although cervical dysplasia can lead to cervical cancer, it is in no way a cancer diagnosis.

Pap smear findings are classified into several different categories:

  • ASCUS (Atypical Cells of Undetermined Significance): An ASCUS pap smear result is considered to be mildly abnormal. This is the most common type of abnormal Pap smear. It basically means there were very mild changes and the cause could not be determined. The cause of the abnormal findings could be due to infection, irritation, or precancerous changes. ASCUS is not considered to be cervical dysplasia until further tests confirm it.
  • AGUS (Atypical Glandular cells of Undetermined Significance): AGUS refers to glandular cells that may originate in the cervical canal or uterus. Although not technically cervical dysplasia, AGUS can indicate underlying serious conditions. AGUS results are considered rare, resulting in less than one percent of Pap smear results.
  • LGSIL (Low-Grade Squamous Intraepithelial Lesion): An LGSIL result means that mild dysplasia, more than likely caused by the human papillomavirus, has been detected. It is the most common classification of cervical dysplasia, and in most cases, clears up on its own within two years.

An alternative grading method of classifying the degree of cervical dysplasia is by using the term CIN (cervical intraepithelial neoplasia).

CIN identifies how much of the lining of the cervix is invaded by abnormal cells.

CIN Classifications

  • CIN I: Mild dysplasia; abnormal cells can be found in 1/3 of the lining of the cervix
  • CIN II: Moderate dysplasia; abnormal cells can be found in 2/3 of the lining of the cervix
  • CIN III:
  • Severe dysplasia; abnormal cells can be found in more than 2/3 of the lining of the cervix and up to the full thickness of the lining

It is important to note that cervical dysplasia is not cancer. It is a precancerous condition that when left untreated, could develop into cervical cancer.

Symptoms of Cervical Dysplasia

There are usually no symptoms experienced with cervical dysplasia. Dysplasia is initially detected through a Pap smear, thus the need to get regular Pap smears.

Why Do Women Get Cervical Dysplasia?

There is a strong link between abnormal cervical changes and HPV , the human papillomavirus. HPV is a common virus that most women will be infected with at some time in their life. The good news is that in most cases, HPV clears up on its own and will not cause any abnormal cervical changes.

Other possible risk factors for developing cervical dysplasia are:

  • smoking
  • having multiple sexual partners
  • pregnancy before the age of 20
  • suffering from conditions that affect the immune system, like HIV

Treatment for Cervical Dysplasia

If a Pap smear comes back abnormal, the next step is to have 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 on the severity. Mild to moderate cases of dysplasia often requires no treatment. A "watch and wait" approach is often taken. With this type of treatment, a colposcopy/biopsy is normally done every six to 12 months to see if the dysplasia is clearing up on its own or progressing.

More severe cases of dysplasia require medical treatment. Common treatments include a LEEP , conization, cryosurgery, and other surgical methods.

Once treated, cervical dysplasia can return, so follow up is necessary.


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