Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix. This is not cancer. However, this is considered pre-cancer changes which can lead to cervical cancer if not treated.

According to the World Health Rankings, Russia has 3.5 deaths/100,000 women due to cervical cancer as compared to United Kingdom (1.4/100,000) and Arab countries (0.4/100,000).

It is therefore important for sexually active woman to be viligant of their health as cervical dysplasia do no present any symptoms.

Causes of Cervical Dysplasia

Cervical dysplasia can develop at any age in sexually-active women. Most often, it is due to the Human Papilloma Virus (HPV) infection which is usually spread through sexual contact.

There are many types of HPV viruses and some are high-risk for causing cervical dysplasia and some cause genital warts.

Risk Factors for Cervical Dysplasia

The risk factors for cervical dysplasia include early onset of sexual activity, multiple sexual partners (either of the partners), previous sexually-transmitted disease (STD), immune-suppression (either due to drugs or illness) and smoking.

Testing for Cervical Dysplasia

Women do not normally know that they have cervical dysplasia unless they have been examined by a doctor through pap smear. A HPV DNA test can also be carried out to identify the high-risk HPV linked to cervical cancer.

Cervical dysplasia that is seen on pap smear is called squamous intraepithelial lesion (SIL). This can be categorized into 4 types of abnormal changes.

  • Low-grade lesion (LSIL)
  • High-grade lesion (HSIL)
  • Possibly cancerous (malignant)
  • Atypical glandular cells (AGUS)

If cervical dysplasia is found on pap smear, the patient is usually advised to have a biopsy of the cervix to obtain histological confirmation of the diagnosis. This may be done using one of the following methods.

  • Colposcopy (a magnified exam of the cervix to detect abnormal cells so that biopsies can be taken) and cervical punch biopsy
  • LEEP (loop electrosurgical excision procedure)
  • Cone biopsy (laser or cold knife)

Once the histology is confirmed, the abnormal changes seen on the cervix is called cervical intraepithelial neoplasia (CIN) and it is categorized into 3 groups.

  • CIN I          (mild dysplasia)
  • CIN II         (moderate dysplasia)
  • CIN III        (severe dysplasia or carcinoma in-situ)

Treatment of Cervical Dysplasia

The treatment of cervical dysplasia depends on the degree of dysplasia. For mild dysplasia, it may resolve on its own without treatment and a repeat pap smear is required after 6 months. However, if the dysplasia is persistent and is diagnosed as moderate to severe condition, then treatment is usually required to remove the abnormal cells to reduce the risk of cervical cancer.

Treatment may include:

  • Cryosurgery          to freeze abnormal cells
  • Laser                     uses light to burn away abnormal cells
  • LEEP                     uses electricity to remove abnormal tissue
  • Cone biopsy          uses either laser or cold knife to remove abnormal tissue
  • Hysterectomy       removes the whole uterus (in rare cases)

 

With early diagnosis and prompt treatment, cervical dysplasia can be cured. However, this condition may return if there is persistent HPV infection.

Without treatment, cervical dysplasia can develop into invasive cancer after 10 to 15 years.

Girls who received HPV vaccines before they become sexually active reduce their risk of getting cervical cancer. Other measures include quit smoking and have routine Pap smears.