Cervical dysplasia is the name for abnormal changes of squamous cells on the surface of the cervix. These changes are not neoplastic but can develop into cancerous cells if left untreated. Changes are usually initiated by the common human papilloma virus (HPV) after spreading through sexual contact.
Usually cervical dysplasia is symptomless.
Entire Body System
(disorder) 92564006 Carcinoma in situ of uterine cervix (disorder) Clinical Pearls HPV is present in virtually all cervical cancers (99.7%), but most HPV infections are transient. [unboundmedicine.com]
The procedure takes about 10 to 15 seconds, but it can trigger uterine cramping. A procedure called dilatation and curettage (D & C) may be performed if the physician suspects that abnormal cells extend beyond the cervix. [healthcommunities.com]
A diagnosis requires a pelvic examination and a Pap-smear (Papanicolaou test) from a sample collected in the endocervical canal.
Unusual findings are usually complemented by more sensitive tests before any therapy is initiated .
Squamous intraepithelial lesions (SIL) of the cervix identified with histopathology are graded as:
- LSIL = Low-grade SIL
- HSIL = High-grade SIL
- malignant cells - possibly cancerous
- Atypical glandular cells (AGUS).
Subsequent testing procedures depend on the nature of the original changes detected.
- Mild LSIL changes can be followed with another pap smear;
- More severe changes can be investigated with a biopsy – colonoscopy-directed or cone biopsies – or a Loop Electrosurgical Excision Procedure (a LEEP excision) may be performed after a colonoscopy using a thin, low-voltage electrified wire to remove abnormal cervical tissue.
Cervical intraepithelial neoplasia (CIN) is identified from a biopsy and can be graded into three:
- mild dysplasia- CIN I
- moderate to marked dysplasia - CIN II
- severe dysplasia to carcinoma in situ - CIN III.
The level of treatment varies with the level of dysplasia. Mild cases (LSIL or CIN I) may resolve with no treatment but should be followed with Pap smears every 6-12 months to ensure they have disappeared 
Treatment for moderate-to severe dysplasia or mild dysplasia that does not resolve after two years may include – 
The prognosis is very favourable if the condition is diagnosed early, although it may recur.
However, severe dysplasia without treatment may progress into an invasive neoplasm. Critically this may take many years .
HPV, especially the high-risk HPV types 16, 18,31 and 33, are the major cause of cervical dysplasia causing changes in squamous cells of the cervix .
Cervical dysplasia can develop at any age, but is more often identified in women between 25 and 35 years of age .
It is generally caused by HPV of which there are several types, including ones that can cause genital warts .
Factors which increase the risk of cervical dysplasia include -
The HPV virus can be introduced into the female tract by a symptomless carrier and once inside the womb it causes cytological abnormalities of the surface squamous cells. Transient infections will be removed from the body as a result of the immune defences and the abnormal cells will disappear. Oncogenic viruses, however, will cause more serious changes that will lead to larger lesions and, if untreated, these may develop into a cervical squamous cell carcinoma .
Routine clinical examination and Pap-smears are recommended with patients who have suffered from dysplasia with a re-examination at least every 12 months.
An HPV DNA test can be used to identify high-risk types of virus that are linked with cancer. This test can be done either as a screening test for women over 30 years or those who return a mildly abnormal Pap-test result.
HPV vaccines are available that should be administered before both boys and girls become sexually active .
- Good diet;
- No smoking;
- HPV vaccination between the ages of 9 and 25 years;
- No sexual activity until 18 years or older;
- Practise safe-sex with a condom;
- Practise monogamy;
- Routine pap smears to detect early changes (recommendations on frequency vary depending on an individual’s associated risk factors).
Definition: Cervical dysplasia is the name for abnormal changes of squamous cells on the surface of the cervix that are not neoplastic but can develop into a malignant cancer if left untreated.
Cause: Changes are usually initiated the common human papilloma virus (HPV) after spreading through sexual contact.
Symptoms: The condition is symptomless.
Diagnosis: Diagnosis requires a pelvic examination and a Pap-smear (Papanicolaou test) from a sample collected in the endocervical canal. Histopathology will identify the nature of the changes and lead to recommendation of specific treatment for more advanced cases.
Treatment: Mild cases usually resolve themselves without treatment but smears should be repeated at least every 12 months.
Treatment for moderate-to severe dysplasia or mild dysplasia that does not resolve after two years may include:
- Cryosurgery (kills abnormal cells with freezing),
- Laser therapy (burns away abnormal cells with light),
- LEEP excision – (removes abnormal tissues with low-voltage electricity),
- Hysterectomy (rare).
Prevention: Prevention of cervical dysplasia includes:
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