What is the definition of Cervical Dysplasia?

Cervical dysplasia refers to abnormal changes in the cells 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 they can lead to cancer of the cervix if not treated.

What are the alternative names for Cervical Dysplasia?

Cervical intraepithelial neoplasia - dysplasia; CIN - dysplasia; Precancerous changes of the cervix - dysplasia; Cervical cancer - dysplasia; Squamous intraepithelial lesion - dysplasia; LSIL - dysplasia; HSIL - dysplasia; Low-grade dysplasia; High-grade dysplasia; Carcinoma in situ - dysplasia; CIS - dysplasia; ASCUS - dysplasia; Atypical glandular cells - dysplasia; AGUS - dysplasia; Atypical squamous cells - dysplasia; Pap smear - dysplasia; HPV - dysplasia; Human papilloma virus - dysplasia; Cervix - dysplasia; Colposcopy - dysplasia

What are the causes for Cervical Dysplasia?

Cervical dysplasia can develop at any age. However, follow-up and treatment will depend on your age. Cervical dysplasia is most commonly caused by the human papillomavirus (HPV). HPV is a common virus that is spread through sexual contact. There are many types of HPV. Some types lead to cervical dysplasia or cancer. Other types of HPV can cause genital warts.

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
• Maternal history of exposure to DES (diethylstilbestrol)

What are the symptoms for Cervical Dysplasia?

Most of the time, there are no symptoms.

What are the current treatments for Cervical Dysplasia?

Treatment depends on the degree of dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment.

• You may only need careful follow-up by your provider with repeat Pap tests every 6 to 12 months.
• If the changes do not go away or get worse, treatment is needed.

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 had dysplasia, you will need to have repeat exams every 12 months or as suggested by your provider.

Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers.

What is the outlook (prognosis) for Cervical Dysplasia?

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.

When should I contact a medical professional for Cervical Dysplasia?

Call your provider if your age is 21 or older and you have never had a pelvic exam and Pap test.

How do I prevent Cervical Dysplasia?

Ask your provider about the HPV vaccine. Girls who receive this vaccine before they become sexually active reduce their chance of getting cervical cancer.

You can reduce your risk of developing cervical dysplasia by taking the following steps:

• Get vaccinated for HPV between ages 9 to 45.
• Do not smoke. Smoking increases your risk of developing more severe dysplasia and cancer.
• Do not have sex until you are 18 or older.
• Practice safe sex. Use a condom.
• Practice monogamy. This means you have only one sexual partner at a time.

REFERENCES

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American College of Obstetricians and Gynecologists. Practice Bulletin No. 140: management of abnormal cervical cancer screening test results and cervical cancer precursors. Obstet Gynecol. 2013;122(6):1338-1367. PMID: 24264713 pubmed.ncbi.nlm.nih.gov/24264713/.

Armstrong DK. Gynecologic cancers. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 189.

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Hacker NF. Cervical dysplasia and cancer. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 38.

Immunization Expert Work Group, Committee on Adolescent Health Care. Committee Opinion No. 704: human papillomavirus vaccination. Obstet Gynecol. 2017;129(6):e173-e178. PMID: 28346275 pubmed.ncbi.nlm.nih.gov/28346275/.

Robinson CL, Bernstein H, Poehling K, Romero JR, Szilagyi P. Advisory Committee on Immunization Practices Recommended immunization schedule for children and adolescents aged 18 years or younger - United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(5):130-132. PMID: 32027628  pubmed.ncbi.nlm.nih.gov/32027628/.

Salcedo MP, Baker ES, Schmeler KM. Intraepithelial neoplasia of the lower genital tract (cervix, vagina, vulva): etiology, screening, diagnosis, management. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 28.

Saslow D, Solomon D, Lawson HW, et al; ACS-ASCCP-ASCP Cervical Cancer Guideline Committee. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147-172. PMID: 22422631 pubmed.ncbi.nlm.nih.gov/22422631/.

US Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(7):674-686. PMID: 30140884 pubmed.ncbi.nlm.nih.gov/30140884/.