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(Cervical Intraepithelial Neoplasia [CIN]; Precancerous Changes of the Cervix)
Michelle Badash, MS
Dysplasia is abnormal growth or development of cells. Cervical dysplasia happens in the cells covering the surface of a woman's cervix. If cervical dysplasia is not treated, it may lead to
Cervical dysplasia is caused by a sexually transmitted virus. The virus is called the
This virus causes abnormal changes in the cells of the cervix. The most significant cervical change would be cancer.
There are different types of HPV. The risk of cervical disease may be high or low depending on the type of HPV.
Procedures to detect cervical dysplasia include the following:
can help diagnose or monitor cervical dysplasia. Cells are collected from your cervix. They are sent to a lab for analysis. If abnormal cell growth is found, a
may be done.
HPV DNA Analysis
This will test for both the presence and type of HPV in cervical tissues. The presence of abnormal cells and high-risk HPV DNA increases the risk of significant disease. In this case, more evaluation and treatment will be needed.
If further evaluation of the cervix is necessary, then a colposcopy will be performed. During this procedure, the cervix is lightly coated with a vinegar solution. The solution will highlight abnormal cells.
A magnifying scope is then used to examine the cervix.
will be done on any areas that show abnormal changes. A biopsy is the removal of tiny bits of tissue. A sample of the cells of the canal of the cervix will also be taken. This is done with a small brush. The biopsy and the sample of cells from the cervical canal will be sent to a lab for analysis. In the lab, abnormal cell growth will be classified as one of the following:
Treatment depends on the severity of dysplasia, location, and size of the area of abnormal cells. Some cervical changes do not need treatment. They may be followed by periodic Pap tests to monitor for any further changes. Some types of dysplasia may disappear on its own. If dysplasia does not resolve on its own, these treatments options are available:
A topical medication that is used to treat cancer may be applied to your cervix. The medication will help stop the abnormal cells from growing.
This biopsy is the removal of a tiny, cone-shaped piece of tissue. The sample is taken from the opening of the cervix and the cervical canal. The biopsy tissue will be analyzed. The results will show whether any of the abnormal cell growth is cancerous.
Loop Electrosurgical Excision Procedure (LEEP) TOP
A small biopsy of the cervix is taken with a wire loop heated by electric current. The results will show whether any of the abnormal cells are precancerous or cancerous.
Note: Both cone biopsy and LEEP biopsy techniques remove all abnormal tissue. These procedures may be used for very early, noninvasive cancer treatment and diagnosis.
Laser treatment uses a concentrated, high-energy beam of light to destroy abnormal cells. This method is more favorable than cryosurgery. There is less destruction of surrounding normal tissue. Although, healing is faster than with other methods and laser treatment is expensive. It is not always available.
against HPV infection. The HPV vaccine called Gardasil is approved for use in females aged 9-26 years old. The HPV vaccine called Cervarix is approved for females aged 10-25 years old.
Talk to your doctor about when you should have Pap tests done. Professional health organizations have differing guidelines.
If you are age 21-29 years, you should have the Pap test every two to three years.
If you are age 30-65, you should have the Pap test along with the HPV test every three to five years.
If you are age 65 or older, you may be able to stop having Pap and HPV tests if you have had normal results (such as, three normal results in a row and no abnormal results in the past 10 years).
You will need to have Pap tests done more often if you have abnormal results. You may also need more frequent testing if you have certain conditions, like a suppressed immune system or a history of cervical dysplasia or cervical cancer. Talk to your doctor about the right screening schedule for you.
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6/17/2014 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Rahangdale L, Lippmann QK, et al. Topical 5-fluorouracil for treatment of cervical intraepithelial neoplasia 2: a randomized controlled trial. Am J Obstet Gynecol. 2014 Apr;210(4):314.e1-8.
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