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Dysplasia of Cervix

Dysplasia of the Cervix is where there is a change in cervix tissue. This can be a very early lesion that is referred to as “Pre-Cancerous“.

This can be a complicated topic due to the misunderstanding of cancer.  Dysplasia of the Cervix is not cancer.

However, the change occurs from the normal cells of the Cervix to a different cell type can lead to cancer if not monitored and in some cases treated. 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 the sexual transmission of HPV. HPV is a virus called Human Papillomavirus.

Risk factors

1.)  HPV infection
2.)  Sex at an early age
3.)  Multiple sexual partners
4.)  Sexual partners who have had multiple sexual partners
5.)  Smoker
6.)  Immunosuppression

Diagnosis

1.)  Typical detection is an abnormal Pap Smear (Papanicolaou smear)

2.)  Pap smear should start at age 21 or 3 years following the beginning of the sexual activity

3.)  After age 65-70 if no abnormal smears on last 3 you may stop having pap smears

4.)  A biopsy of the Cervix or lesion may be indicated

Several classifications exist of the severity of dysplasia

Numerical Dysplasia CIN

1.)  CIN 1  –  Benign
2.)  CIN 2  –  Benign with inflammation
3.)  CIN 3
.  Grade I  –  Mild dysplasia
.  Grade II  –  Moderate dysplasia
.  Grade III  –  Severe dysplasia

Cervical Cancer

1.)  Carcinoma in situ
2.)  Invasive Cancer Invasive Cancer

ASC-US

–  ASC-US can be found on the cytology reports indicating atypical squamous cells of unknown significance.

The presence of HPV indicates a need for Colposcopy if no HPV than follow-up in 1 year.

Prevention

1.)  Prevention is a key – Prophylactic vaccination for cervical cancer exists called GardasilTM.

2.)  Gardasil currently prevents against strains 6,11,16 and 18. It is recommended for women 11 to 26.

3.)  Cervarix another medication should be approved soon which covers 16 and 18.

4.)  Essentially risk factors are closely associated with the number of sexual partners.

5.)  Diaphragms and condoms can reduce risk factors.

6.)  Other forms of birth control such as oral contraceptives have no protective effect.

Treatment includes:

–   cryosurgery or cauterization
–   Loop resection
–   Reoccurring follow-up appointments.