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Cervical Dysplasia

What You Need to Know About Cervical Dysplasia and Cancer

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Updated April 30, 2007

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.
  • HGSIL (High Grade Squamous Intraepithelial Lesion): HGSIL is a more serious classification of cervical dysplasia. If left untreated, it could lead to cervical cancer.
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 dyplasia. 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 upon the severity. Mild to moderate cases of dysplasia often require 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 dyplasia is clearing up on its own or progressing.

More severe cases of dyplasia 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.



References:
  1. "Cervical Cancer (PDQ®): Screening ." Natural History, Incidence, and Mortality . 21 July 2006. National Cancer Institute. 17 Oct 2006 <http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_cervical_cancer_8.asp>.
  2. Solomon, MD, Diane, Diane Davey, MD; Robert Kurman, MD; Ann Moriarty, MD; Dennis O'Connor, MD; Marianne Prey, MD; Stephen Raab, MD; Mark Sherman, MD; David Wilbur, MD; Thomas Wright, Jr, MD;Diana, Nancy Young, MD; . "The 2001 Bethesda System Terminology for Reporting Results of Cervical Cytology ." The Journal of The American Medical Association 287(2002):
  3. "National Cancer Institute Fact Sheets." Human Papillomaviruses and Cancer: Questions and Answers. 06 June 2006. National Cancer Institute. 17 Oct 2006 <http://www.cancer.gov/cancertopics/factsheet/Risk/HPV>.
  4. Josefson, Deborah . "Mild cervical dysplasia often reverts to normal." British Medical Journal 31813 February 1999 17 October 2006 <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1114903>.
  5. Kaferle, M.D., Joyce, JEAN M. MALOUIN, M.D., M.P.H.. "Evaluation and Management of the AGUS Papanicolaou Smear ." American Family Physcian 63(2001):

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