What Is Cervical Dysplasia?

The basics of cervical dysplasia

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Cervical dysplasia is a common condition that describes abnormal precancerous changes to the cervix. Abnormal changes can range from mild to severe and are detected through a routine Pap smear.

Cervical Dysplasia and Cervical Cancer

Although untreated cervical dysplasia may lead to cervical cancer in some cases, having cervical dysplasia does not mean that a person has cancer or will ever develop the disease.

It is commonly treated first with monitoring to see if it persists, and then with outpatient procedures in the doctor's office. In other words, with careful monitoring and treatment, the abnormal changes in the cervix are usually treated (removed) before they have the opportunity to transform from precancerous cells to cancer cells.

Cervical Dysplasia Symptoms

Women with cervical dysplasia do not usually have any symptoms. This is the reason why having a regular Pap smear is so important. A regular Pap smear can detect these abnormal cervical changes long before they turn cancerous.

Cervical Dysplasia Causes

There is a strong connection between the human papillomavirus (HPV) and cervical dysplasia. HPV is a common virus spread through sexual contact. For most women, HPV and cervical dysplasia will clear up on their own without medical treatment. However, for some women, HPV can lead to severe abnormal cervical changes.

When these changes are left untreated, they can lead to cervical cancer.

Studies also show that women who smoke increase their risk of developing cervical dysplasia. It has been found that smoking can actually accelerate the effects of HPV on the cervix. This is yet another reason to kick the smoking habit as early as possible in life.



Other possible cervical dysplasia risk factors include:

Cervical Dysplasia Diagnosis

Cervical dysplasia is diagnosed by lab analysis of the Pap test, which takes a brush sample of the cells of the cervix. The lab looks for abnormal cells. If they report atypical squamous cells of uncertain significance (ASC-US), the test may be repeated in 12 months and an HPV test may also be performed.

With repeat abnormal findings or if the HPV test is positive and you are over age 25, a biopsy may be done. This biopsy is done during a procedure called colposcopy and samples cervical cells that can then be further analyzed to determine if they are pre-cancerous, cervical intraepithelial neoplasia (CIN). These are graded as CIN1 (mild dysplasia), CIN2 (moderate dysplasia) and CIN3 (severe dysplasia or carcinoma in situ.)

Cervical Dysplasia Treatment

Treatment of cervical dysplasia depends upon the biopsy results noted above and varies with the degree of dysplasia which is present.

CIN I is not usually treated. Instead, it is most often followed closely with Pap smears, HPV tests, or sometimes colposcopy.

Treatment is usually done for CIN II and CIN II and involves removing the areas of abnormal cells so they can't continue to grow and to become cancerous.

Treatment options may include:

  • Cryosurgery - This surgery involves inserting a frozen probe in order to freeze the abnormal tissue.
  • LEEP - A LEEP procedure (loop electrosurgical procedure) uses an electrically charged wire to remove abnormal tissue.
  • Laser surgery - A carbon dioxide laser may be used to treat the abnormal tissue.
  • Cold knife cone biopsy - This procedure is similar to the above but instead uses a surgical scalpel to remove the suspicious tissue.

    A local anesthetic is often used to numb the tissue on the cervix before these procedures, which are frequently done in the clinic or hospital as a same-day surgery. If the biopsy shows that there are abnormal cells at the edges of the sample, further treatment is done of the area to ensure they have removed all of the abnormal cells.

    The recurrence rate for CIN in one large study was 5.3 percent for women treated with cryosurgery or LEEP and 1.4 percent for those treated with cold knife conization, although the frequency of complications was somewhat higher with cold knife conization.

    Follow Up After Dysplasia

    If your cervical dysplasia is treated with one of the methods above, you will need to be monitored frequently. If abnormal cells return, treatment is repeated. Since an HPV infection can persist after treatment of CIN, there is a risk of further areas of abnormal tissue developing in the future. Make sure to talk to your doctor so that you understand any follow up that is recommended.

    Coping with Cervical Dysplasia

    It can be very frightening to hear you have a condition which could lead to cancer. That said, as long as you follow up carefully with your doctor and receive any treatments suggested, the likelihood of this transformation is very low.

    Sources:

    Hoffman, S., Le, T., Lockhart, A. et al. Patterns of Persistent HPV Infection After Treatment for Cervical Intraepithelial Neoplasia (CIN): A Systematic Review. International Journal of Cancer. 2017 Jan 25. 

    Santesso, N., Mustafa, R., Wiercioch, W. et al. Systematic Reviews and Meta-Analysis of Benefits and Harms of Cryotherapy, LEEP, and Cold Knife Conization to Treat Cervical Intraepithelial Neoplasia. International Journal of Gynaecology and Obstetrics. 201. 132(3):266-71.

    Tsikouras, P., Zervoudis, S., Manav, B. et al. Cervical Cancer: Screening, Diagnosis and Staging. J BUON. 2016. 21(2):320-5.

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