Dysplasia is abnormal growth or development. In cervical dysplasia, it happens in the cells covering the surface of the cervix. In some cases this may be a precancerous change. If not treated, it may lead to cervical cancer.

Cervix

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This condition is caused by a sexually transmitted virus. The virus is called the human papillomavirus (HPV). It causes the abnormal changes in the cells of the cervix. There are different types of HPV. They can be high or low risk. The level of risk is based on their ability to cause significant cervical disease. The most significant disease would be cancer.

Risk Factors

Factors that increase your risk of cervical dysplasia include:

• Sex: female
• Multiple sexual partners
• Early onset of sexual activity (before age 18)
• Early childbearing (before age 16)
• Smoking
• Sexually transmitted diseases (especially HPV)
• Genital herpes
• HIV
• Exposure to diethylstilbestrol (DES) in utero (in the womb)—an estrogen-like substance given to prevent miscarriages in high-risk pregnancies

Symptoms

There are often no overt symptoms. The changes are found by the tests listed below.

Diagnosis

Procedures to detect cervical dysplasia include the following:

Pap Smear

Regular pap smears can help diagnose or monitor cervical dysplasia. Cells are collected from your cervix. They are sent to a lab for analysis. If abnormal cell growth is found, a colposcopy may be done. In this process, the cervix is examined through a low power microscope.

HPV DNA Analysis

This will test for both the presence and the type of HPV in cervical tissues. There are many HPV types. Some are more high-risk for cancer than others. The test is often done with the newer liquid-based pap smear. The presence of abnormal cells and high-risk HPV DNA increases the risk of significant disease. In this case, more evaluation and treatment will be needed.

Colposcopy and Biopsy

The cervix is lightly coated with a vinegar solution. This will highlight abnormal cells. A magnifying scope is used to examine the cervix. A biopsy will be done on any area that shows abnormal changes. A biopsy is the removal of tiny bits of tissue. A sample of the cells of the canal of the cervix will also be taken. This is done with a small brush. The biopsy and the sample of cells from the cervical canal will be sent to a lab for analysis. In the lab abnormal cell growth will be classified as one of the following:

• Mild
• Moderate
• Severe (carinoma-in-situ)
• Cancerous

Treatment

Treatment depends on the severity of dysplasia, location, and size of the area of abnormal cells. A high or low grade is also an important factor. Low-grade changes do not usually need treatment. They may be followed by periodic Pap smears. Low-grade dysplasia often disappears on its own. Treatment methods include:

Cone Biopsy

This biopsy is the removal of a tiny cone-shaped piece of tissue from the opening of the cervix. The biopsy tissue will be analyzed. The results will show whether any of the abnormal cell growth is cancerous.

Loop Electrosurgical Excision Procedure (LEEP)

A small biopsy of the cervix is taken with a wire loop heated by electric current. The results will show whether any of the abnormal cells are pre-cancerous or cancerous.

Note: Both cone biopsy and LEEP biopsy techniques remove all the abnormal tissue in question. These procedures may be used for cancer treatment and diagnosis.

Cryosurgery

Cryosurgery freezes and destroys the dysplasia on the cervix. This method is not recommended for treating large areas of dysplasia.

Laser Treatment

Laser treatment uses a concentrated, high-energy beam of light to destroy abnormal cells. This method is more favorable than cryosurgery. There is less destruction of surrounding normal tissue. Although healing is faster than with other methods, laser treatment is expensive. It is not always available.

Cancer Treatment

Cone biopsy and LEEP are usual cures for dysplasia. However, if the cone biopsy or LEEP biopsy shows invasive cancer:

• Surgery
• Radiation therapy
• Chemotherapy

Your doctor will discuss these options with you.

Cervical dysplasia should be followed up with often. Talk to you doctor about a Pap test schedule. Test may be scheduled every 3-6 months.

Prevention

Lifestyle Changes

To reduce the risk of cervical dysplasia, take these steps:

• Use safe sex methods to prevent HPV infection.
• If you smoke, quit.
• Talk to your doctor about when you should have Pap tests done. The current recommendations are:
  • If you are aged 21-29 years—have the Pap test every two years
  • If you are aged 30 or older—have the Pap test every three years
  • If you are aged 65 or older—You may be able to stop having Pap tests if you have had three normal results in a row and no abnormal results in the past 10 years.
  • Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, like a suppressed immune system or a history of cervical dysplasia or cervical cancer. Talk to your doctor about the right screening schedule for you.
• Get vaccinated against HPV infection. The HPV vaccine called Gardasil is approved for use in females aged 9-26 years old. The HPV vaccine called Cervarix is approved for females aged 10-25 years old.