ADAM Health Encyclopedia

Cervical dysplasia

Definition

Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, this is considered a precancerous condition.

Cervical dysplasia is grouped into three categories:

• CIN I -- mild dysplasia (a few cells are abnormal)
• CIN II -- moderate to marked dysplasia
• CIN III -- severe dysplasia to carcinoma-in-situ (precancerous cells only in the top layer of the cervix)

Alternative Names

Causes

Most cases of cervical dysplasia occur in women aged 25 to 35.

The cause is unknown. However, the following may increase your risk:

• Multiple sexual partners
• Becoming sexually active before age 18
• Giving birth before age 16
• If your mother took a drug called diethylstilbestrol (DES) during pregnancy
• Sexually transmitted infections, especially HIV or HPV (genital warts)

Symptoms

There are usually no symptoms.

Exams and Tests

A pelvic examination is usually normal.

A Pap smear shows abnormal cells. A colposcopy-directed biopsy is done to confirm the condition and determine its severity.

Other tests may be done to find out if the abnormal cells have spread outside the cervix:

• Endocervical curettage
• Cone biopsy

Treatment

Treatment depends on the degree of dysplasia. Mild dysplasia may go away on its own . You may only need careful observation by your doctor with repeat Pap smears every 3 to 6 months.

Treatment for moderate to severe dysplasia or dysplasia that does not go away may include:

• Cryosurgery
• Electrocauterization
• Laser vaporization to destroy the abnormal tissue
• Surgery to remove the abnormal tissue

Women with dysplasia need consistent follow-up, usually every 3 to 6 months or as recommended by their provider.

Outlook (Prognosis)

Early diagnosis and prompt treatment cures nearly all cases of cervical dysplasia.

Without treatment, 30-50% of cases of severe cervical dysplasia may lead to invasive cancer. The risk of cancer is lower for mild dysplasia.

Possible Complications

The condition may return.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you are a woman who is sexually active or aged 20 or older and you have never had a pelvic examination and Pap smear.

See: Physical exam frequency

Prevention

To reduce the chance of developing cervical dysplasia:

• Wait until you are 18 or older before becoming sexually active
• Practice monogamy and use condoms during intercourse

Noller KL. Intraepithelial Neoplasia of the Lower Genital Tract (Cervix, Vulva) : Etiology, Screening, Diagnostic Techniques, Management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap. 28.

Wright TC Jr, Cox JT, Massad LS, Twiggs LB, Wilkinson EJ; ASCCP-Sponsored Consensus Conference. 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002 Apr 24;287(16):2120-9. Review.

Hoffman MS, Martino MA. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol. 2004 Sep;191(3):1049