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Cervical dysplasia

Dysplasia means abnormal development of organs or cells or an abnormal structure resulting from such growth and when such abnormalities appear in the inner lining of the cervix, the condition is defined as cervical dysplasia.

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It’s a precancerous condition, which can later lead to cancer if not treated early.

Symptoms of Cervical dysplasia

Cervical dysplasia doesn’t show up any symptoms. However, rarely there could be symptoms of abnormal vaginal bleeding, spotting post intercourse, genital warts and lower back pain.

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Causes of Cervical Dysplasia

The primary cause behind developing this kind of abnormality is human papillomavirus (HPV) infection and the virus is sexually transmitted. Women below the age of 30 years are susceptible to contracting the virus; nonetheless it can occur at any age.

Some factors that increase chances of infection are:

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  • Persistent HPV infection- infected with high risk HPV (HPV-16, HPV-18)
  • Multiple sexual partners
  • Having sexual intercourse in very early age
  • Weak immune system- AIDs, use of immunosuppressant drugs, tobacco addiction
  • Low risk HPV (HPV 6 and HPV 11) mostly cause genital warts

Diagnosis of Cervical Dysplasia

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A Pap test is done to screen women with cervical dysplasia. The screening begins with a pelvic exam wherein a small portion of tissue is swabbed from the cervix to perform a microscopic examination. The Pap smear may be repeated.

If the results show abnormalities then the patient will have to undergo the following tests:

  • Colposcopy is performed with a colposcope to get magnified view of the cervix
  • Cone biopsy or loop electrosurgical excision procedure (LEEP)- the tissue sample is cut in the shape of a cone with an electrified wire loop, which is further sent for biopsy to rule out for cancer
  • HPV DNA testing: to identify potential strains of HPV virus capable of causing cancer

Interpretation of test results

Pap smear results indicate squamous intraepithelial lesion, or SIL, which are of the following categories:

  • low-grade squamous intraepithelial lesion LSIL
  • High-grade squamous intraepithelial lesion HSIL
  • ASC-US: atypical squamous cells of undetermined significance

Presence of precancerous changes in tissue biopsy samples of the cervix is termed as cervical intraepithelial neoplasia (CIN) and it’s of the following types:

  • CIN 1 – low grade lesion or mild dysplasia
  • CIN 2 -  high-grade lesion, moderate dysplasia
  • CIN 3 – high grade lesion, severe dysplasia or carcinoma in situ

Treatment of Cervical Dysplasia

The treatment is absolutely dependent on the degree of cervical dysplasia. Mild dysplasia doesn’t require any immediate treatment since it can heal spontaneously. However, pap smears are repeated every 3-6 months to monitor the changes.

In cases of CIN 1 and CN 2, the treatment options include either ablation (destruction or removal of the abnormal cells) or resection (removal). The following techniques are involved:

  • LEEP procedure to remove the abnormal cells
  • Cryosurgery (freezing)- The abnormal cells are cryo- frozen with nitric oxide
  • Laser surgery or carbon dioxide laser photoablation- use of CO2 laser beam to vaporize the abnormal cervical tissue
  • Electrocauterization- destroying the precancerous tissue by applying heat from a electrically heated metal probe.

Prevention of Cervical Dysplasia

  • Several precautions can be taken to avoid HPV infections which are:
  • Practice safe sex and using protection (condoms)
  • Getting HPV vaccines early through 9 to 26 years of age
  • Avoiding multiple sexual partners
  • Waiting till 18 years for sexual initiation
  • Get first cervical screening or pelvic exam at the age of 21

Early treatment cures cervical dysplasia in most of the cases, however it can reappear later. So we advice all women to undergo an early screening or pelvic exam because delay in diagnosis and treatment transforms the dysplasia into cancer.

Written by: Saptakee sengupta
Date last updated: January 11, 2015