Cervical Dysplasia

What is cervical dysplasia?

Cervical dysplasia is an abnormal growth of cells on the cervix. The cervix is the lower part of the uterus that opens into the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus. Another term for cervical dysplasia is cervical intraepithelial neoplasia, or CIN.

Dysplasia is not cancer, but it can become cancer of the cervix if it is not treated.

How does it occur?

You have a greater risk for cervical dysplasia if:

• You had sexual intercourse before the age of 18.
• You have had more than 2 sex partners.
• You smoke.
• You have had genital warts, genital herpes, or HIV/AIDS.
• You have had unprotected sex with multiple partners.
• You have not had enough folic acid in your diet.

What are the symptoms?

Cervical dysplasia usually does not cause symptoms. Sometimes it causes bleeding during or after sexual intercourse.

How is it diagnosed?

Cervical dysplasia is diagnosed by a simple, painless test called a Pap test. To do a Pap test, your health care provider swabs your cervix and cervical canal with a long cotton swab, brush, or wooden stick. Cells from the cervix are sent to a lab to be viewed under a microscope. The Pap test can be done in your health care provider's office.

If your health care provider wants a closer look at the cervix, you may have a colposcopy. For this procedure a colposcope (an instrument with a magnifying lens) is placed at the opening of the vagina and used to look closely at the cervix. Small samples of any tissue that appears abnormal may be removed and sent to the lab for tests. The removal of this sample is called a biopsy.

How is it treated?

It is very important to have dysplasia treated to help stop it from becoming cervical cancer. The specific treatment may depend on whether the dysplasia is mild, moderate, or severe.

Mild cervical dysplasia, also called CIN 1, often goes away without treatment. If you have mild dysplasia, you should have another Pap test in 4 to 6 months. If the Pap test still shows mild dysplasia, your health care provider may recommend colposcopy.

If you have moderate dysplasia, called CIN 2, your provider may freeze, burn, or use a laser to destroy the abnormal tissue. The abnormal tissue can also be removed with a thin wire loop attached to an electrical unit. This is called the loop electrosurgical excisional procedure (LEEP). You do not have to stay in the hospital for any of these procedures. They can be done in your provider's office.

For severe dysplasia, called CIN 3, your provider will do a cone biopsy, which is the removal of a cone-shaped piece of the cervix. This procedure is also called conization of the cervix. It removes the tissue containing abnormal cells. Your provider can cut the tissue out with a surgical knife, cautery (burning tool), laser, or wire loop. If the procedure is done with a knife or laser, it is usually done in an operating room. The tissue removed is examined in the lab to check for cancer.

Very few women have trouble getting pregnant or have miscarriages as a result of any of these treatments, including cone biopsies. If you become pregnant and have had a cone biopsy, tell your prenatal care provider about it. Most women who have had a cone biopsy are able to become pregnant and carry the baby to term without problems.

How can I take care of myself?

After a Pap test that shows cervical dysplasia, follow your health care provider's advice for treatment and checkups. Your provider may recommend that you have a Pap test at least twice a year for the next 2 to 3 years. This will allow your provider to detect any recurrence of the dysplasia and treat it promptly. Then, if your Pap tests have been normal, you may need the test just once a year.

How can I help prevent cervical dysplasia?

To lower your risk of cervical dysplasia:

• Do not have sex, or practice safe sex by using latex or polyurethane condoms.
• If you are having sex, have just one partner who is not sexually active with anyone else.
• Avoid sexual intercourse until you are 18 or older.
• Do not smoke. Avoid breathing smoke from other people's cigarettes.
• Try to eat foods that contain folic acid. Such foods include black-eyed peas, chickpeas, chicken liver, oranges, brewer's yeast, and spinach.