Cervical dysplasia Health Article

Definition

Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, it is considered a precancerous condition.

Cervical dysplasia is grouped into three categories:

• CIN I -- mild dysplasia (only the lower one-third of cells in the upper layer of the cervix are abnormal)
• CIN II -- moderate to marked dysplasia (up to two-thirds of the layer contains abnormal cells)
• CIN III -- severe dysplasia to carcinoma-in-situ (precancerous cells are in the entire top layer of the cervix)

Alternative Names

Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix

Causes, incidence, and risk factors

Most cases of cervical dysplasia occur in women aged 25 to 35, although it can develop at any age.

While all causes of cervical dysplasia are not known, most cases of cervical cancer and severe dyplasia are caused by infection of the cervix with a persistent, high-risk strain of human papilloma virus (HPV).

The following may increase your risk of cervical dysplasia:

• Becoming sexually active before age 18
• Giving birth before age 16
• If your mother took a drug called diethylstilbestrol (DES) during pregnancy
• Multiple sexual partners
• Other illnesses or medications that suppress your immune system
• Persistent, high-risk HPV (genital warts) infection of the cervix
• Smoking

Symptoms

There are usually no symptoms.

Signs and tests

A pelvic examination is usually normal.

A Pap smear shows abnormal cells. A colposcopy-directed biopsy is done to confirm the condition and determine its severity.

Other tests may be done to find out if the abnormal cells have spread outside the cervix. These include:

• Cone biopsy
• Endocervical curettage

Treatment

Treatment depends on the degree of dysplasia. Mild dysplasia may go away on its own. You may only need careful observation by your doctor with repeat Pap smears every 3 to 6 months.

Treatment for moderate-to-severe dysplasia or dysplasia that does not go away may include:

• Cryosurgery
• Electrocauterization
• Laser vaporization to destroy the abnormal tissue
• LEEP procedure using electrocautery to remove abnormal areas
• Surgery to remove the abnormal tissue (cone biopsy)

Rarely, a hysterectomy may be recommended. Women with dysplasia need consistent follow-up, usually every 3 to 6 months or as recommended by their provider.