(Cervical Intraepithelial Neoplasia [CIN]; Precancerous Changes of the Cervix)
Dysplasia is abnormal growth or development of cells. Cervical dysplasia happens in the cells covering the surface of a cervix. If cervical dysplasia is not treated, it may lead to cervical cancer.
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Cervical dysplasia is most often caused by a sexually transmitted virus. The virus is called the human papillomavirus (HPV).
There are different types of HPV. The risk of cervical disease will differ based on the type of HPV.
Things that may increase the chance of cervical dysplasia include:
- Having multiple sexual partners
- Early onset of sexual activity (before age 18)
- Having children at an early age (before age 16)
- Sexually transmitted diseases including genital herpes or HIV
- Exposure to diethylstilbestrol (DES) as a fetus—substance given to prevent miscarriages in high-risk pregnancies
There are often no symptoms with cervical dysplasia. Cervical changes are most often found in screening tests.
Cervical dysplasia is often found as part of regular screening. A pap tests takes a sample of cervix cells. The sample is sent to a lab for testing. After a pap test cervical dysplasia may be diagnosed as:
- ASCUS (atypical squamos cells of undetermined significance)—Can be caused common issues such as infections, cysts, polyps, or hormonal changes.
- LSIL (low-grade squamos intra-epithelial lesion)—Changes are mild and often caused by HPV infection.
- HSIL (high-grade squamos intra-epithelial lesion)—Caused by HPV and can become cervical cancer.
- ASCH (atypical squamos cells)—May be HSIL. Will need more testing.
- AGC (atypical glandular cells)—May be cancer or precancer.
- AIS (adenocarcinoma in situ)—Advanced changes with high risk of becoming cancer.
A colposcopy and biopsy may be done after abnormal Pap test. A small sample of abnormal cells will be removed and tested at a lab. It will help to get more information on cell changes.
Testing for HPV may also be done since it is a common cause of cervical dysplasia.
Note: pap test screening will be done more often after abnormal results.
Treatment will vary based on type, location, and area that is affected. Some dysplasia does not need treatment or will go away on its own. Regular pap tests will be done to track changes.
Cervical dysplasia that increases the risk for cancer will be treated. The goal of treatment is to destroy or remove abnormal cells. Options include:
- Cone biopsy—a cone-shaped area of tissue is removed. It should remove all abnormal cells.
- LEEP—a wire loop is used to remove abnormal tissue.
- Cryosurgery—abnormal tissue is destroyed with cold. Can only be used for smaller areas of dysplasia.
- Laser Treatment—high-energy beam of light is used to destroy abnormal cells. It tends to cause less damage to nearby healthy tissue than cryosurgery. Laser is not always available.
American Congress of Obstetricians and Gynecologists
American Sexual Health Association
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 168: Cervical Cancer Screening and Prevention. Obstet Gynecol. 2016 Jan;127(1):e1.
Cervical cancer screening. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T116761/Cervical-cancer-screening. Accessed March 9, 2021.
Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/index.html. Accessed March 9, 2021.
Management of Abnormal Cervical Cytology. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-abnormal-cervical-cytology. Accessed March 9, 2021.
Massad LS, Einstein MH, Huh WK, et al; 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2013 Apr;17(5 Suppl 1):S1-S27
Last reviewed March 2021 by EBSCO Medical Review Board Last Updated: 3/9/2021