Dysplasia is a change in cervix tissue.
It is a very early lesion that is referred to as “Pre-Cancerous”
The change occurs from the normal cells of the cervix to a different cell type.
Most cases of dysplasia of cervix remain stable and do not continue to cervical cancer.
A transformation zone may appear, which can continue from dysplasia to metaplasia which is a process towards neoplasm or cervical cancer
The main factor associated with dysplasia is sexual transmission of HPV.
HPV is a virus called Human Papillomavirus
Risk factors
1.) HPV infection
2.) Sex at early age
3.) Multiple sexual partners
4.) Sexual partners who have had multiple sexual partners
5.) Smoker
6.) Immunosuppression
Typical detection is an abnormal Pap Smear (Papanicolaou smear)
Pap smear should start at age 21 or 3 years following beginning of sexual activity
After age 65-70 if no abnormal smears on last 3 you may stop having pap smears
Several classifications exists of severity of dysplasia
Numerical Dysplasia CIN
CIN 1 - Benign
CIN 2 - Benign with inflammation
CIN 3
. Grade I - Mild dysplasia
. Grade II - Moderate dysplasia
. Grade III - Severe dysplasia
Cervical Cancer
- Carcinoma in situ
- Invasive Cancer Invasive Cancer
ASC-US – can be found on cytology report indicating atypical squamous cells of unknown significance.
Presence of HPV indicates a need for Colposcopy, if no HPV than follow-up in 1 year.
Biopsy may be indicated
Prevention is a key – Prophylactic vaccination for cervical cancer exists called GardasilTM.
Gardasil currently prevents against strains 6,11,16 and 18. It is recommended for women 11 to 26.
Cervarix another medication should be approved soon which cover 16 and 18.
Essentially risk factors are closely associated with number of sexual partners.
Diaphragms and condoms can reduce risk factors.
Other forms of birth control such as oral contraceptive have no protective effect.
Treatment includes:
- cryosurgery or cauterization
- loop resection
- and reoccurring follow-up appointments.