Cervical Dysplasia

Cervical dysplasia is the presence of abnormal cells on the surface of the cervix (the opening of the uterus).

Cervical dysplasia isn't cancer but it is considered a precancerous condition.

Cervical dysplasia can range from mild to severe, depending on the appearance of the abnormal cells. Another term for cervical dysplasia is cervical intraepithelial neoplasia, or CIN.

There are three types of cervical dysplasia:

• CIN I - mild dysplasia (only the lower one-third of cells in the upper layer of the cervix are abnormal)
• CIN II - moderate 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)

The exact cause of cervical dysplasia is not known, however it has been linked to the human papillomavirus (HPV). Your immune system may also play a role in the development of cervical dysplasia.

The following may increase a woman's risk of cervical dysplasia:

• Human papillomavirus (HPV) infection
• HIV infection
• Genital warts
• Smoking
• Becoming sexually active before age 18
• Giving birth before age 16
• Exposure to diethylstilbestrol (DES)
• Multiple sex partners
• Other illnesses or medications that suppress your immune system
• History of sexually transmitted diseases

There are usually no symptoms. Cervical dysplasia is typically discovered during an annual Pap smear, making regular screening critical to early detection and treatment, and the prevention of cervical cancer.

A Pap smear is required to diagnose cervical dysplasia, conducted as part of a pelvic exam.

If the Pap smear is abnormal, a colposcopy may be performed. A colposcopy is an office procedure that uses a special microscope (colposcope) to examine the tissue lining the cervix and walls of the vagina for abnormal areas. If needed, small samples of tissue (biopsy) can be removed to examine for signs of cancer.

Treatment depends on the degree of dysplasia.

Mild dysplasia may go away on its own, meaning the cervical tissue returns to normal without treatment. These cases may require only close observation and repeat Pap smears every three to six months.

Moderate to severe dysplasia, or dysplasia that does not go away on its own, may require surgical removal of the abnormal tissue to prevent the risk of developing cervical cancer. Surgical procedures, many of which can be performed in an outpatient setting, include:

• Cryocauterization or cryosurgery. Uses extreme cold to freeze or destroy abnormal cervical tissue.
• Laser therapy. Destroys abnormal cervical tissue using a beam of light.
• Loop electrosurgical excision procedure (LEEP). Uses a thin wire loop that carries an electric current to remove abnormal tissue.
• Surgery (cone biopsy or cervical conization). Involves removing a small cone-shaped sample of abnormal tissue from the cervix.

Lifestyle habits that may help prevent cervical dysplasia include practicing safe sex and not smoking.

Regular Pap smears are the most effective means of detecting cervical dysplasia and treating it before it progresses to cervical cancer.