Cervical Dysplasia

What is cervical dysplasia?

Cervical dysplasia is a precancerous condition in which abnormal cells grow on the surface of your cervix. The cervix is the opening to your uterus that’s attached to the top portion of your vagina. Another name for cervical dysplasia is cervical intraepithelial neoplasia, or CIN. “Intraepithelial” means that the abnormal cells are present on the surface (epithelial tissue) of your cervix and have not grown past that surface layer. The word “neoplasia” refers to the growth of abnormal cells.

How serious is cervical dysplasia?

Hearing the word “precancerous” can be scary, but it’s important to remember that most people with cervical dysplasia don’t get cancer. Receiving a cervical dysplasia diagnosis means that you may — not that you will — develop cervical cancer if you don’t have recommended treatments. If cancer does form, it takes years to develop, giving your healthcare provider time to find and remove problem areas.

What are the classifications of cervical dysplasia?

Cervical dysplasia was once classified as mild, moderate or severe, based on how likely abnormal cells would become cancerous. A more recent system classifies disease severity based on how much epithelial tissue in your cervix has abnormal cells. Cervical intraepithelial neoplasia (CIN) is classified on a scale from one to three.

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

CIN 1 cervical dysplasia rarely becomes cancer and often goes away on its own. CIN 2 and 3 are more likely to require treatment to prevent cancer.

Who does it affect?

Cervical dysplasia affects people who’re sexually active with the reproductive parts associated with being assigned female at birth (AFAB) — including cisgender women and transgender men and nonbinary people with a cervix. People who’re AFAB who are infected with the human papillomavirus (HPV) can develop cervical dysplasia. HPV is the most common sexually transmitted infection (STI) in the United States.

How common is cervical dysplasia?

About 250,000 to 1 million cisgender women in the U.S. get diagnosed with cervical dysplasia each year. The condition occurs most often among women of childbearing age, particularly aged 25 to 35.

What are the symptoms of cervical dysplasia?

Cervical dysplasia doesn’t usually cause symptoms. Instead, your healthcare provider may diagnose you with cervical dysplasia after finding abnormal cells during a routine Pap smear. Some people may have irregular vaginal spotting or spotting after intercourse.

What causes cervical dysplasia?

You can get cervical dysplasia if you become infected with HPV, a virus that’s spread through sexual contact. In many cases, your immune system will get rid of the virus. Over 100 strains of HPV exist. Some strains, such as HPV-16 and HPV-18, are more likely to infect your reproductive tract and cause cervical dysplasia.

Scientists estimate that more than 75% of sexually active cisgender women are infected with HPV at some point during their lives. About 50% of HPV infections occur between the ages of 15 and 25. Often, the infections go away without causing permanent problems. In rare cases, abnormal cells form over time, leading to cervical dysplasia.

Can you have dysplasia without HPV?

No. You have to have HPV to develop cervical dysplasia. But having HPV doesn’t necessarily mean that you’ll develop cervical dysplasia.

It’s unknown why some people develop cervical dysplasia after being infected with HPV while others don’t. Some high-risk strains of HPV and the duration of the infection may play a role. Risk factors include:

• Being over age 55. Studies have shown that HPV infections often last longer in people over 55. Infections often clear up more quickly in people who are 25 or younger.
• Smoking cigarettes. Smoking and using products that contain tobacco can double your risk of cervical dysplasia.
• Having a weakened immune system. Using immunosuppressant drugs can make it harder for your body to fight an HPV infection. Becoming infected with the human immunodeficiency virus (HIV) makes it harder for your body to fight infection, too. A weakened immune system, along with an HPV infection, can lead to cervical dysplasia.

How is cervical dysplasia diagnosed?

Your healthcare provider will most likely notice signs of cervical dysplasia during a routine Pap smear. If the Pap smear is unclear or reveals abnormal cells, the next step might be a colposcopy to examine your cervix.

A colposcopy can take place in your healthcare provider’s office. During the procedure, your healthcare provider looks through a lighted instrument called a colposcope to check for abnormal cells in your cervix or vaginal walls.

Your healthcare provider might perform a biopsy to remove tissue samples that’ll be examined in a laboratory. They may order a DNA test to see whether a high-risk form of HPV is present, too.

How is cervical dysplasia treated?

Treatment depends on various factors, including the severity of your cervical dysplasia, age, health and treatment preferences. Procedures to treat cervical dysplasia can impact future pregnancies. Speak with your healthcare provider about treatments available to you if you’re pregnant or plan on becoming pregnant in the future.

Monitoring abnormal cells

With low-grade cervical dysplasia, classified as CIN 1, you likely won’t need treatment. In the majority of these cases, the condition goes away on its own. Only about 1% of cases progress to cervical cancer. Your healthcare provider may choose a conservative approach that calls for periodic Pap smears to monitor any changes in abnormal cells.

Removing or destroying abnormal cells

If your cervical dysplasia is more severe (CIN 1 or CIN 2), your healthcare provider can remove the abnormal cells that may become cancerous or destroy them.

These procedures may include:

• Loop electrosurgical excision procedure (LEEP) uses a small, electrically charged wire loop to remove tissue. LEEP can also remove tissue samples for further analysis. About 1% to 2% of people may experience complications following the procedure, such as delayed bleeding or narrowing of their cervix (stenosis).
• Cold knife cone biopsy (conization) involves your healthcare provider removing a cone-shaped piece of tissue containing the abnormal cells. It was once the preferred method of treating cervical dysplasia, but now it’s reserved for more severe cases. Conization can provide a sample of tissue for further testing. It has a somewhat higher risk of complications, including cervical stenosis and postoperative bleeding.
• Hysterectomy involves removing your uterus. A hysterectomy may be an option in cases where cervical dysplasia persists or doesn’t improve after other procedures.

Can cervical dysplasia be cured?

Yes. Removing or destroying the abnormal cells cures cervical dysplasia in about 90% of all cases. Cervical dysplasia rarely progresses to cancer. When it does progress, it does so very slowly, allowing time for your healthcare provider to intervene.

How can cervical dysplasia be prevented?

The only way to prevent cervical dysplasia is to avoid getting HPV. If you already have an HPV infection, you can reduce the risk of it developing into cervical cancer by getting regular Pap smears. Pap smears won’t prevent cervical dysplasia, but regular Pap smears can diagnose cervical dysplasia to prevent it from progressing to cancer.

• Get vaccinated against HPV. Getting vaccinated is the best way to prevent HPV and cervical dysplasia. The U.S. Food and Drug Administration (FDA) has approved three vaccines that prevent the types of HPV most closely associated with cervical dysplasia: Gardasil®, Gardasil 9® and Cervarix®. The U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone aged 9 to 26 receive the vaccine. If you’re between 27 and 45, speak with your healthcare provider about the potential benefits of getting vaccinated. Although it can’t treat pre-existing HPV or cervical dysplasia, the vaccine may prevent infections from returning in some cases.
• Practice 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. Use condoms or dental dams when having sex. Limit your number of sexual partners.
• Get regular Pap smears. You should have your first Pap smear at age 21. If your Pap smears remain normal, current recommendations suggest a repeat Pap every three years from 21 to 29. You should have a Pap and HPV test every five years if you’re between ages 30 and 65. Pap smears can’t prevent cervical dysplasia, but they can detect it early.
• Don’t smoke or use tobacco products. There’s a greater chance that an HPV infection could become cervical dysplasia — including more severe forms of cervical dysplasia — if you’re someone who smokes or uses tobacco.

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 reduces the risk of cervical cancer by 95% in cisgender women with high-grade dysplasia in the first eight years after treatment.

When should I see my healthcare provider?

Your healthcare provider will likely monitor your health closely following a cervical dysplasia diagnosis to ensure cells don’t grow back or become cancerous. You may have more frequent Pap smears and HPV tests, too.

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

What questions should I ask my doctor?

• Should I get the HPV vaccination?
• How severe is my cervical dysplasia?
• Am I considered high-risk for developing cervical cancer?
• What does my cervical dysplasia diagnosis mean for my pregnancy?
• What types of tests should I receive to monitor my condition? How often should I receive them?
• How do treatment options for cervical dysplasia affect my chances of becoming pregnant someday?

What exactly is cervical dysplasia?

Getting a cervical dysplasia diagnosis means that you have abnormal cells on your cervix that could become cervical cancer. What happens next depends on how serious your condition is, your health and other factors.

Can you feel cervical dysplasia?

No. Cervical dysplasia doesn’t cause symptoms, although sometimes you may notice vaginal spotting. Abnormal cells found during a Pap smear are often the first sign of the condition.

Is cervical dysplasia caused by HPV?

Yes. Having an HPV infection is the most important risk factor for developing cervical dysplasia.

A note from Cleveland Clinic

Learning that you have precancerous cells on your cervix is scary, but cervical dysplasia doesn’t always lead to cancer. Early diagnosis and treatment can prevent cervical cancer from ever forming. In the meantime, take preventive measures to prevent cervical dysplasia by protecting yourself from HPV. Get vaccinated for HPV. Practice safer sex. And don’t skip a Pap smear appointment.