Definition
Cervical dysplasia is the abnormal growth of cells on the surface of the cervix . Although this is not cancer, this is considered a pre-cancerous condition. Depending on the extent of changes, the condition is further categorized as:
- CIN I -- mild dysplasia (a few cells are abnormal)
- CIN II -- moderate to marked dysplasia
- CIN III -- severe dysplasia to carcinoma-in-situ ( cancer confined to the surface layer of the cervix)
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Definition
Cervical dysplasia is the abnormal growth of cells on the surface of the cervix . Although this is not cancer, this is considered a pre-cancerous condition. Depending on the extent of changes, the condition is further categorized as:
- CIN I -- mild dysplasia (a few cells are abnormal)
- CIN II -- moderate to marked dysplasia
- CIN III -- severe dysplasia to carcinoma-in-situ ( cancer confined to the surface layer of the cervix)
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Symptoms
There are usually no symptoms.
Causes
Less than 5% of all Pap smear test results find cervical dysplasia. While the cause is unknown, a number of risk factors have been identified. Most cases occur in women aged 25 to 35.
Other risk factors include:
- Multiple sexual partners
- Starting sexual activity before age 18
- Having children before age 16
- DES exposure
- Having had sexually transmitted diseases, especially HPV ( genital warts ) or HIV infection
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Treatment
The treatment depends on the degree of dysplasia. Mild dysplasia, which may go away on its own, usually involves careful observation with repeat Pap smears every 3 to 6 months. Other forms may require methods to destroy the abnormal tissue, including electrocauterization , cryosurgery , laser vaporization, or surgical removal.
Consistent follow-up, every 3 to 6 months or as prescribed, is essential.
Other Names
Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix
Possible Complications
The condition may return.
Outlook (Prognosis)
Nearly all cervical dysplasia can be cured with early identification, proper evaluation and treatment, and careful, consistent follow-up.
Without treatment, 30-50% cases of cervical dysplasia may progress to invasive cancer. The risk of cancer is higher for severe dysplasia (CIN III) that is not treated.
Prevention
To reduce the chance of developing cervical dysplasia:
- Wait until you are 18 or older before becoming sexually active
- Practice monogamy and use condoms during intercourse
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Exams and Tests
A pelvic examination is usually normal.
The following tests may indicate cervical dysplasia:
- Pap smear showing mild, moderate, marked, or severe dysplasia.
- Colposcopy revealing "white epithelium." These are mosaic-like patterns on the surface of the cervix, caused by changes in the surface blood vessels.
- Colposcopy-directed biopsy to confirm dysplasia and the extent of cervical involvement.
- Endocervical curettage to rule out involvement of the cervical canal.
- Cone biopsy may be necessary to rule out invasive cancer.
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References
Wright TC Jr, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ; ASCCP-Sponsored Consensus Conference. 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA . 2002 Apr 24;287(16):2120-9. Review.
Hoffman MS, Martino MA. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol . 2004 Sep;191(3):1049
