(Cervical Intraepithelial Neoplasia [CIN]; Precancerous Changes of the Cervix)
Cervical dysplasia is the abnormal growth or development of the cells covering the surface of the cervix. If cervical dysplasia is not treated, it may lead to cervical cancer.
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Cervical dysplasia is most often caused by a sexually transmitted virus called human papillomavirus (HPV).
There are different types of HPV. The risk of cervical disease will differ based on the type of HPV.
Things that may raise the risk of cervical dysplasia are:
- Having multiple sexual partners
- Early onset of sexual activity (before age 18)
- Having children at an early age (before age 16)
- Sexually transmitted infections including genital herpes or HIV
- Exposure to diethylstilbestrol (DES) as a fetus—a substance given to prevent miscarriages in high-risk pregnancies
There are often no symptoms with cervical dysplasia. Cervical changes are most often found in screening tests.
Cervical dysplasia is often found as part of regular screening. A sample of cervix cells are taken for testing. This is done with a pap test.
A colposcopy and biopsy may be done after an abnormal Pap test. A small sample of abnormal cells will be removed and tested at a lab. It will help to get more information on cell changes.
Testing for HPV may also be done since it is a common cause of cervical dysplasia.
Some dysplasia will not need treatment and will go away on its own. The doctor will monitor for any changes.
In others, the goal of treatment is to destroy or remove abnormal cells. How this is done depends on how much of the cervix is affected. Options are:
- Cryosurgery—abnormal tissue is destroyed with cold to treat smaller areas of dysplasia
- Laser Treatment—a high energy beam of light is used to destroy abnormal cells
- Loop electrosurgical excision procedure (LEEP)—a wire loop is used to remove abnormal tissue
- Cone biopsy—a cone-shaped area of tissue is taken to remove abnormal cells
The risk of cervical dysplasia may be lowered by:
- Practicing safe sex to lower the risk of HPV infection.
- Avoiding smoking
- Getting the HPV vaccine that is available to those who are 9 to 45 years of age.
- Cervical cancer screening. EBSCO DynaMed website. Available at: https://www.dynamed.com/prevention/cervical-cancer-screening.
- Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/index.html.
- Management of Abnormal Cervical Cytology. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-abnormal-cervical-cytology.
- Massad LS, Einstein MH, Huh WK, et al; 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2013 Apr;17(5 Suppl 1):S1-S27
- Elizabeth Margaret Prusak, MD
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