Cervical dysplasia or cervical lesions are terms used to describe the existence of abnormal cells on the surface of the cervix. Cervical dysplasia can occur at any age after a woman becomes sexually active. Left untreated, dysplasia can progress to an early form of cancer known as cervical carcinoma in situ, and eventually to invasive cervical carcinoma. Dr. Malone, can you tell us more about cervical dysplasia?
Certainly, Dr. Patel. Cervical dysplasia is most commonly associated with human papillomavirus infections, known as HPV. The risk of developing HPV infections increases with multiple sexual partners and sexual activity during the teenage years.
Cervical dysplasia does not cause symptoms. This is unfortunate, because the existence of symptoms could help providers diagnose cervical cancer at an earlier stage. Early detection is critical for the effective treatment of cervical dysplasia. The most commonly used test to diagnose cervical dysplasia is routine screening with a Pap test.
Cervical dysplasia appears on a Pap test, often referred to as a Pap smear, as something called squamous intraepithelial lesion, or SIL. Classifications of SIL include:
- Low-grade, or LSIL
- High-grade, or HSIL
- Possibly cancerous
- Atypical glandular cells, or AGUS, and
- Atypical squamous cells
If a Pap smear shows abnormal cells, more tests will be needed. Mild changes may simply require follow-up Pap tests, but other times, a biopsy or colposcopy may be needed to confirm diagnosis. When dysplasia is seen on a biopsy, it’s called cervical intraepithelial neoplasia, or CIN. CIN is grouped into three categories, which include:
- CIN I, or mild dysplasia
- CIN II, or moderate to marked dysplasia, and
- CIN III, or severe dysplasia to carcinoma in situ
Cervical dysplasia can be treated in a variety of ways. In some cases, the provider may choose to observe the abnormal cells to see if they’ll disappear on their own. In young women especially, the body is often successful in clearing dysplasia without treatment, but the provider should continue to monitor the condition. In other cases, the provider may choose to remove abnormal tissue using an excisional procedure known as Loop Electrosurgical Excision Procedure, or LEEP. A cone biopsy may be another option for removing abnormal tissue.
Another treatment option involves freezing the cervix to remove abnormal tissue using a procedure called cryosurgery. Laser surgery can also be used to vaporize the abnormal tissue. In these two procedures, little or no damage occurs to surrounding tissue, but no tissue is obtained to verify the extent of the disease.