Cervical dysplasia
Definition
Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, this is considered a precancerous condition.
Cervical dysplasia is grouped into three categories:
- CIN I -- mild dysplasia (a few cells are abnormal)
- CIN II -- moderate to marked dysplasia
- CIN III -- severe dysplasia to carcinoma-in-situ (precancerous cells only in the top layer of the cervix)
Alternative Names
Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervixCauses
Most cases of cervical dysplasia occur in women aged 25 to 35.
The cause is unknown. However, the following may increase your risk:
- Multiple sexual partners
- Becoming sexually active before age 18
- Giving birth before age 16
- If your mother took a drug called diethylstilbestrol (DES) during pregnancy
- Sexually transmitted infections, especially HIV or HPV (genital warts)
Symptoms
There are usually no symptoms.
Exams 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:
- Endocervical curettage
- Cone biopsy
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
- Surgery to remove the abnormal tissue
Women with dysplasia need consistent follow-up, usually every 3 to 6 months or as recommended by their provider.
Outlook (Prognosis)
Early diagnosis and prompt treatment cures nearly all cases of cervical dysplasia.
Without treatment, 30-50% of cases of severe cervical dysplasia may lead to invasive cancer. The risk of cancer is lower for mild dysplasia.
Possible Complications
The condition may return.
When to Contact a Medical Professional
Call for an appointment with your health care provider if you are a woman who is sexually active or aged 20 or older and you have never had a pelvic examination and Pap smear.
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
References
Noller KL. Intraepithelial Neoplasia of the Lower Genital Tract (Cervix, Vulva) : Etiology, Screening, Diagnostic Techniques, Management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap. 28.
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
Reviewed By: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
