Cervical dysplasia refers to abnormal cells found on the surface of the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.
The changes are not cancer, but are considered to be precancerous. If left untreated, dysplasia can lead to cancer of the cervix. Cells in dysplasia are similar to cancer cells, but they don’t invade other organs.
Cause
The following may increase your risk for cervical dysplasia:
- Having sex before age 18
- Having a baby at very young age
- Having had multiple sexual partners
- Having other illnesses, such as tuberculosis or HIV
- Using medicines that suppress your immune system
- Smoking
Most of the time, there are no symptoms.
Diagnosis
A pelvic exam, a Pap smear and a test for the presence of HPV are common in diagnosing dysplasia.
Cervical dysplasia that is seen on a Pap smear is called squamous intraepithelial lesion (SIL). On the Pap smear report, these changes will be described as:
- Low-grade (LSIL)
- High-grade (HSIL)
- Possibly cancerous (malignant)
- Atypical glandular cells (AGC)
- Atypical squamous cells (ASC)
Dysplasia that is seen on a biopsy of the cervix is called cervical intraepithelial neoplasia (CIN). It is grouped into 3 categories:
- CIN I — mild dysplasia
- CIN II — moderate to marked dysplasia
- CIN III — severe dysplasia to carcinoma in situ
Some strains of HPV are known to cause cervical cancer. An HPV DNA test can identify the high-risk types of HPV linked to this cancer. This test may be done:
- As a screening test for women over age 30
- For women of any age who have a slightly abnormal Pap test result
Treatment
Mild dysplasia (LSIL or CIN I) may go away without treatment with a careful follow-up every 6 to 12 months.
Treatment for moderate-to-severe dysplasia or mild dysplasia that does not go away may include:
- Cryosurgery to freeze abnormal cells
- Laser therapy, which uses light to burn away abnormal tissue
- LEEP (loop electrosurgical excision procedure), which uses electricity to remove abnormal tissue
- Surgery to remove the abnormal tissue (cone biopsy)
- Hysterectomy (in rare cases)
If you have a negative Pap test and HPV test at that appointment, your doctor may recommend resuming Pap tests and HPV testing every three to five years.
Prognosis
Early diagnosis and prompt treatment cures most cases of cervical dysplasia. However, the condition may return.
Without treatment, severe cervical dysplasia may change into cervical cancer.
