Cervical Dysplasia

Cervical dysplasia is a precancerous condition in which abnormal cells grow on the surface of your cervix. Your cervix is attached to the top of your vagina. It’s at the opening of your uterus.

Hearing the word “precancerous” can be scary. But most women with cervical dysplasia don’t develop cervical cancer. Receiving a cervical dysplasia diagnosis means that you might — not that you will — develop cervical cancer. Careful monitoring and treatments often prevent this. That’s why it’s important to see your gynecologist regularly for screenings.

Another name for cervical dysplasia is cervical intraepithelial neoplasia (CIN). “Intraepithelial” means the abnormal cells are on the surface (epithelium) of your cervix. They haven’t grown past that surface layer. “Neoplasia” means abnormal cell growth.

CIN stages

Healthcare providers classify the severity of cervical intraepithelial neoplasia (CIN) based on how much of the tissue looks abnormal under a microscope:

• CIN 1: Abnormal cells affect about one-third of the thickness of the epithelium.
• CIN 2: Abnormal cells affect about one-third to two-thirds of the epithelium.
• CIN 3: Abnormal cells affect more than two-thirds of the epithelium.

CIN 1 rarely becomes cancer and often goes away on its own. CIN 2 and 3 are more likely to require treatment to prevent cancer. About 100,000 women receive treatment for cervical dysplasia each year in the U.S.

Symptoms of cervical dysplasia

Cervical dysplasia doesn’t usually cause symptoms. But some women may have irregular vaginal bleeding or spotting after intercourse.

Most women who have cervical dysplasia find out they have it after a routine Pap smear.

Cervical dysplasia causes

A virus called HPV (human papillomavirus) causes cervical dysplasia. HPV is the most common viral sexually transmitted infection (STI) in the U.S.

If you have cervical dysplasia, you have HPV. Some women have HPV but don’t develop cervical dysplasia.

Over 100 strains of HPV exist. In many cases, your immune system will get rid of the virus. But some strains, like HPV-16 and HPV-18, are more likely to cause cervical dysplasia.

Risk factors

Researchers don’t know why some women with HPV develop cervical dysplasia while others don’t.

Risk factors include:

• Smoking cigarettes. Smoking and using products that contain tobacco can double your risk of cervical dysplasia.
• Having a weakened immune system. This makes it harder for your body to fight an HPV infection.

The strain of HPV and how long you’ve had the untreated infection may also play roles in developing cervical dysplasia.

How doctors diagnose this condition

Your healthcare provider may notice signs of cervical dysplasia during a routine internal exam. They may do a test called a Pap smear. This is when your provider collects a sample of cervical cells that a pathologist can look at under a microscope. If the Pap smear reveals abnormal cells, you may need a:

• Colposcopy: Your provider performs and internal exam with a lighted instrument to check for abnormal cells in your cervix or vaginal walls.
• Biopsy: Your provider removes tissue samples that a pathologist examines in a laboratory.

Your healthcare provider will go over the results with you. Together, you’ll determine the next steps for treatment.

What is the treatment for cervical dysplasia?

Treatment depends on various factors like:

• The severity of cervical dysplasia.
• Your age and overall health.
• Your treatment preferences.

Procedures to treat cervical dysplasia can impact pregnancy. Your healthcare provider will go over your options if you’re pregnant or plan to become pregnant.

CIN 1 treatment

With low-grade cervical dysplasia (CIN 1), you likely won’t need treatment. Most of these cases go away on their own. Only about 1% of CIN 1 cases eventually progress to cervical cancer.

Your healthcare provider may recommend periodic Pap smears to watch for any worsening changes in abnormal cells.

CIN 2 and CIN 3 treatment

If the cervical dysplasia is more severe (CIN 2 or CIN 3), your provider may recommend removing or destroying the abnormal cells. These procedures cure cervical dysplasia in about 90% of all cases.

The procedures include:

• Loop electrosurgical excision procedure (LEEP): Your provider uses a small, electrically charged wire loop to remove tissue.
• Cold knife cone biopsy (conization): Your provider removes a cone-shaped piece of tissue containing the abnormal cells.
• Hysterectomy: Your provider surgically removes your uterus and cervix. This may be an option if cervical dysplasia persists or doesn’t improve after other procedures.

Each of these procedures has risks and potential complications. You and your provider will discuss which option is best for you.

When should I see my healthcare provider?

Your healthcare provider will want to check the health of your cervix over time. They’ll want to make sure abnormal cells don’t grow back or become cancerous.

Following treatment, they may recommend that you have a follow-up Pap smear every three to six months for one to two years. Afterward, you may resume having yearly Pap smears.

What can I expect if I have this condition?

The outlook for cervical dysplasia with early diagnosis is excellent. Removing or destroying the abnormal cells significantly reduces your risk of cervical cancer. But these procedures come with certain side effects, like potential issues with pregnancy.

How can I prevent cervical dysplasia?

The only way to prevent cervical dysplasia is to avoid getting HPV. Prevention steps include:

• The HPV vaccine: The HPV vaccine prevents HPV infections that can progress to cervical cancer or genital warts. It can’t treat pre-existing HPV or cervical dysplasia. But it may prevent infections from returning in some cases.
• Abstinence or safer sex: You can prevent HPV infections by avoiding sexual contact, including vaginal, anal and oral sex. You can also reduce your risk by practicing safer sex with condoms.
• Regular Pap smears: Early detection can help prevent severe cervical dysplasia. You should have your first Pap smear at age 21. If your Pap smears remain normal, your provider might recommend repeat tests every three years until age 29. You should have co-testing (Pap Smear with HPV testing) every five years if you’re between the ages of 30 and 65. Testing can’t prevent cervical dysplasia, but it can help with early detection.
• Don’t smoke or use tobacco products: There’s a greater chance that an HPV infection could become cervical dysplasia if you smoke or use tobacco.