McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is cervical dysplasia?

Cervical dysplasia (also called cervical intraepithelial neoplasia, or CIN) is an abnormal growth of tissue in the cervix. The cervix is the lower part of the uterus that opens into the vagina. The uterus is the womb, where menstrual blood is made and where babies grow during pregnancy.

Dysplasia is not cancer, but it can develop into cancer of the cervix. Cervical dysplasia is classified as mild, moderate, or severe.

How does it occur?

Any woman who is or has been sexually active may have cervical dysplasia. It is more common in women who have had many sex partners or began to have intercourse before age 18. Cervical dysplasia has been linked to a sexually transmitted wart virus called human papillomavirus (HPV). In addition, cervical dysplasia is more common in women who smoke cigarettes or have too little folic acid in their diet.

What are the symptoms?

Cervical dysplasia seldom has any symptoms. Sometimes it causes bleeding during or after sexual intercourse.

How is it diagnosed?

Cervical dysplasia is diagnosed by a simple, painless test called a Pap smear. To do a Pap smear, your health care provider swabs your cervix and cervical canal with a long cotton swab, brush, or wooden stick. Cells from the cervix are sent to a lab to be viewed under a microscope. The Pap smear can be done in your health care provider's office, clinic, or hospital.

If your health care provider wants a closer look at the cervix, you may have a colposcopy. For this procedure a colposcope (an instrument with a magnifying lens) is placed at the opening of the vagina and used to look closely at the cervix. Small samples of any tissue that appears abnormal may be removed and sent to the lab for tests.

How is it treated?

Mild cervical dysplasia often goes away without treatment. If you have mild dysplasia, you should have another Pap smear in 4 to 6 months. If the Pap smear still shows mild dysplasia, your health care provider may recommend colposcopy.

If you have moderate dysplasia, your health care provider may freeze, burn, or use a laser to destroy the abnormal tissue. The abnormal tissue can also be removed with a thin wire loop attached to an electrical unit. This is called the loop electrosurgical excisional procedure (LEEP). You do not have to stay in the hospital for any of these procedures. They can be done in your provider's office.

For severe dysplasia, your health care provider will do a cone biopsy, which is the removal of a cone-shaped piece of the cervix. This removes all the tissue containing abnormal cells. Your provider can cut the tissue out with a surgical knife, cautery (burning tool), laser, or wire loop. The tissue removed is examined in the lab to check for cancer.

Very few women have trouble getting pregnant or have miscarriages after any of these treatments, including cone biopsies. If you become pregnant and have had a cone biopsy, tell your prenatal care provider about it. Most women who have had a cone biopsy are able to become pregnant and carry the baby to term without problems.

Whether you have mild, moderate, or severe dysplasia, it is very important to have it checked to make sure it doesn't become cervical cancer.

How can I take care of myself?

• After a Pap smear that shows cervical dysplasia, follow your health care provider's advice for treatment and checkups. Have a Pap smear at least twice a year for the next 2 years, and then once every year. This will allow your health care provider to detect any recurrence of the dysplasia and treat it promptly.
• If you smoke, stop. Avoid breathing smoke from other people's cigarettes.
• Try to eat foods that contain folic acid. Such foods include black-eyed peas, chickpeas, chicken liver, oranges, brewer's yeast, and spinach.

How can I help prevent cervical dysplasia?

To lower your risk of cervical dysplasia:

• Practice safe sex by using condoms or don't have sex.
• If you are having sex, have it with just one sexual partner.
• Avoid sexual intercourse until you are 18 or older.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.