Cervical dysplasia is a precancerous condition characterized by abnormal cell growth on the surface of the cervix, a cylinder-shaped organ that connects the vagina to the uterus. Also known as cervical intraepithelial neoplasia (CIN), this condition can range in severity from mild to severe. Mild cervical dysplasia may resolve on its own, but severe cervical dysplasia may lead to cancer if left untreated.
What causes cervical dysplasia?
The primary cause of cervical dysplasia is the human papillomavirus (HPV), a common sexually transmitted infection (STI). There are more than 200 strains of HPV. Most are low risk and resolve on their own, although some cause genital warts. High-risk HPV strains can also cause cancers of the vagina, vulva, anus, penis, and head or neck.
What are the symptoms of cervical dysplasia?
Cervical dysplasia typically does not cause any symptoms. However, it can often be detected early by gynecologic screening and addressed before it progresses into cancer. For this reason and others, regular gynecological checkups and cervical cancer screenings are recommended for all adult women.
If abnormal cervical cells become cancerous and invade nearby tissues, symptoms of cervical cancer may become apparent. The most common sign is bleeding between menstrual periods, after sexual intercourse or after menopause. Other symptoms can include:
- Unusually heavy or prolonged menstrual bleeding
- Abnormal vaginal discharge
- Pain during sexual intercourse
How is cervical dysplasia diagnosed?
Routine gynecologic screening consists of an HPV test, a Papanicolaou test (Pap smear), or both. If these test results are abnormal, a physician may suggest a diagnostic procedure called colposcopy. During a colposcopy, a physician examines the cervix, vulva and vagina under a high level of magnification to determine if there are abnormal cells, where they are growing and the severity of the abnormality. A sample of cervical cells (cervical biopsy) may also be taken for further testing (biopsy). If the biopsy results show cervical dysplasia, they will be further classified as low-grade intraepithelial lesion (LSIL) vs high-grade intraepithelial lesion (HSIL) or cervical intraepithelial lesion (CIN) 1, 2, or 3.
How is cervical dysplasia treated?
Mild cervical dysplasia, which is classified as LSIL or CIN 1, often does not require treatment. A physician may recommend scheduling a follow-up appointment in a year to monitor the condition and check for further abnormal cell growth.
Severe cervical dysplasia, which may be classified as HSIL or as CIN 2 or 3, often requires removal of the abnormal tissue. Two common methods of removing cervical lesions are:
- Loop electrosurgical excision procedure (LEEP) – Abnormal cells are removed from the cervix with a wire loop heated by an electrical current.
- Cold knife conization – A cone-shaped piece of tissue is removed from the cervix with a scalpel or laser knife.
Both procedures are relatively quick and simple and can be performed in a physician’s office or on an outpatient basis in a hospital.
Can cervical dysplasia be prevented?
Cervical dysplasia and cervical cancer can be prevented by preventing transmission of the HPV virus. The most effective way to prevent transmission is by receiving the HPV vaccination, which protects against nine strains of the virus including the most common cancer-causing strains. Vaccinations should be given to all girls and boys between ages 9-12. If you were not vaccinated as a child, you should ask your doctor about getting the vaccine. Most adults are eligible until the age of 45. You can also reduce transmission of the virus by using barrier methods such as male and female condoms during sexual contact.
Should you see a specialist for cervical dysplasia?
If you’ve received an abnormal HPV or Pap test result, you should consult with a gynecologist or gynecological oncologist who has extensive experience performing a colposcopy. This is the best way to ensure that you will receive an accurate diagnosis and appropriate treatment. Both are key to preventing cervical dysplasia from progressing into cancer. If cervical cancer is identified by your gynecologist, you should be referred to a gynecologic oncologist for specialized treatment. At Moffitt, you will also have access to a Gynecologic Molecular Medicine Tumor Board which reviews each patient’s case to determine the best course of treatment.
Medically reviewed by Kelly Bruce, Department of Gynecologic Oncology
If you have questions about cervical dysplasia or would like to connect with an expert in the gynecological clinic at Moffitt Cancer Center, you can request an appointment by calling 1-888-663-3488 or completing our new patient registration form online. As Florida’s top cancer hospital, we are changing the model, and we will get you started on a personalized treatment plan right away.