Cervical Dysplasia

Alternative Names: Cervical intraepithelial neoplasia (CIN); Precancerous changes of the cervix
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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In some women, the cells of the cervix gradually change from normal to a cancerous state. The condition between these two extremes, when the cells are abnormal with the potential to become cancerous, is known as cervical dysplasia. There are three grades of dysplasia: mild, moderate, and severe. mild dysplasia may return to a normal state, but severe dysplasia may progress to cancer of the cervix if not treated.

Many developed countries, including the US, have established screening programs to check for cervical dysplasia using the pap test. Regular testing, which helps ensure that cervical dysplasia is diagnosed and treated at an early stage before the abnormal cells become cancerous, has led to a dramatic fall in the total number of cases of cancer of the cervix.

Causes: The exact cause of cervical dysplasia is not known, but a number of different risk factors have been identified. for

example, the risk of developing cervical dysplasia appears to be slightly higher after exposure to those types of human

papilloma virus that cause genital warts. other risk factors for the development of cervical dysplasia include unprotected

sex at an early age, and becoming pregnant before age 20. however, exactly how these risk factors are connected to cervical

dysplasia is unknown. smoking also increases the risk of developing cervical dysplasia.

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 .

Symptoms: There are usually no symptoms.

Diagnosis: Cervical dysplasia does not produce symptoms. the condition is only normally diagnosed after a pap test, during which a sample of cells is taken from the cervix and sent for examination under a microscope. If you are found to have abnormal cells, your doctor may arrange for you to have a colposcopy, so that the cervix can be seen through an instrument and examined for abnormal-looking areas. A small sample of tissue may also be removed from the cervix and examined under the microscope for abnormalities.

Exams and Tests:

A pelvic examination is usually normal.

The following tests may indicate cervical dysplasia:

Pap smear showing mild, moderate, marked, or severe dyspepsias.
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 dyspepsias 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.

Treatment:If you are diagnosed with cervical dysplasia, the treatment depends on the degree of abnormality cells revert to normal in up to 4 in 10 cases. however, the disorder will be monitored by pap tests every 6 months. If cervical dysplasia persists or worsens, treatment to destroy or remove the abnormal cells will be needed. after treatment you may have a bloodstained discharge for a few weeks.

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.

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Prognosis: In many cases of cervical dysplasia, the cells of the cervix will return to normal after treatment. However, your condition will be monitored for the next few years to ensure that no further abnormalities develop. about 3 months after treatment, you will have a pap test and colposcopy, followed by regular pap tests every 6 months. The risk of developing cancer of the cervix is higher in cases of severe cervical dysplasia.
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.

When to Contact your 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.

Call for an appointment with your health care provider if you have not had regular Pap smears at these intervals:

Every year initially
For women up to age 35 or 40: every 2-3 years after having three negative, consecutive annual Pap smear tests and a single sexual partner or no sexual partner
*Every year for women over age 35 or 40
*Every year for women who have had multiple sexual partners
*Every year for women who are taking oral contraceptives (birth control pills)
*Every 6 months for women who have a history of HPV (genital warts)
*Every year for DES daughters (women whose mothers took DES during the pregnancy)
The frequency recommended by your health care provider after an abnormal Pap smear or prior dysplasia

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

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


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