Cervical Dysplasia Causes Symptoms and Treatment

 

What is Cervical dysplasia?

Cervical dysplasia (CIN, cervical intraepithelial neoplasia) is a precancerous uterine condition in which an abnormal growth of epithelial cells (squamous cells) occurs on the surface of the cervix or endocervical canal, a spindle-shaped tube between the uterus and the vagina. In most cases, women with cervical dysplasia do not usually have any signs or symptoms, and the condition is most often discovered by a routine pelvic exam, which is usually done along with a Pap smear (papanicolaou test). If your Pap test result shows koilocytes or abnormal cells, your doctor may do a repeat Pap test. However, if the results of the repeat Pap test are still abnormal, you will need to have a test called colposcopy, which is usually done to evaluate an abnormal appearing cervix or an abnormal Pap smear result.

Cervical dysplasia can develop at any age; however, it so common in young women under age 30

How long does it take for cervical dysplasia to develop?

Once squamous cells begin to change, it typically takes 10 to 15 years before before malignant transformation occurs.

Only about one percent of cases of CIN I will progress to cervical cancer. However, without early diagnosis and prompt treatment, about 40% of cases of severe cervical dysplasia progress to invasive cervical cancer.

Cervical dysplasia is a premalignant transformation characterized by abnormal growth of epithelial cells on the surface of the cervix. Cervical dysplasia can range from mild to severe, and is classified into three grades depending on the severity of the condition. There are three grades of cervical cancer: mild (CIN I), moderate (CIN II), and severe cervical dysplasia CIN III. Moreover, There are two main types of cervical cancer: squamous cell carcinoma and adenocarcinoma

What is CIN 1?

CIN I (cervical squamous intraepithelial neoplasia I) or mild cervical dysplasia is a precancerous condition affecting only one third of the thickness of the epithelium and endocervical glands, it is characterized by a low-grade squamous intraepithelial lesion (LGSIL, low grade dyskaryosis) in which only about one-third of the cervical cells (squamous cells) are abnormal. CIN I is usually caused by persistent HPV infection. In most cases, CIN I usually goes away on its own without treatment.

What is CIN 2?

CIN II (cervical squamous intraepithelial neoplasia II) or moderate cervical dysplasia is a precancerous condition affecting two thirds of the thickness of the epithelium and endocervical glands, it is characterized by moderate dyskaryosis in which between one third and two thirds of the cervical cells (squamous cells) are abnormal. CIN II is usually caused by persistent HPV infection. CIN II is not cancer; However, without prompt treatment, precancerous cells may progress to invasive cancers and spread to nearby tissue. The malignant transformation of premalignant lesions usually takes 10 to 15 years.

What is CIN 3?

CIN III (cervical squamous intraepithelial neoplasia III and stage 0 cervical carcinoma in situ) or high-grade severe cervical dysplasia is a precancerous condition affecting the full thickness of the epithelium and endocervical glands, it is characterized by severe dyskaryosis in which about two thirds of the cervical cells (squamous cells) are abnormal. CIN III is usually caused by persistent HPV infection. CIN III is not cancer; However, it is considered as stage 0 (carcinoma in situ) cervical cancer, and for this reason a colposcopy guided cervical biopsy is usually done to diagnose cervical cancer and treatment may be required to remove the abnormal cells. CIN III is unlikely to cure spontaneously and, if left untreated, may eventually become an invasive carcinoma, penetrating the basement membrane.

In CIN III, dysplasia is limited to the surface epithelium and endocervical glands and abnormal cells are present only in the surface layer of the cervix (high-grade squamous intraepithelial lesion or HSIL). Since dysplasia is limited to the surface epithelium, Loop Electrosurgical Excision Procedure (LEEP) has the potential to remove all dysplastic cells.

Symptoms

What are the symptoms of cervical dysplasia?

Cervical dysplasia has no specific symptoms; however, women with cervical dysplasia may experience one or more of the following symptoms:

1. Abnormal vaginal bleeding between periods
2. Dyspareunia or pain during intercourse
3. Severe discomfort and continuous pain, especially if the patient is having an intrauterine device (IUD) inserted
4. Bad mood
5. Depression and emotional lability

Causes

What are the causes of cervical dysplasia?

In most cases, cervical dysplasia is caused by persistent human papillomavirus infection.

About 90% of all women with cervical dysplasia also have HPV infection. However, approximately 90% of HPV infections resolve spontaneously in 2 years and not all women with an HPV infection will develop cervical dysplasia or cancer

Other known risk factors for cervical dysplasia include nulliparity, late menopause, endometrial hyperplasia, obesity, diabetes, hypertension, bad hygiene, sexual perversion, such as having multiple sexual partners, switching between anal and vaginal sex (or visa versa), having vaginal sex after anal intercourse (or visa versa) without changing condom, using a large thick dildo, getting double penetrated, etc.

Treatment

How to treat cervical dysplasia?

Topical treatment for cervical dysplasia

Topical fluorouracil 5% cream (5-FU) applied intravaginally (intravaginal application of 5% 5-fluorouracil) is an effective treatment for cervical intraepithelial neoplasia. Alternatively, cervical intraepithelial neoplasia can be treated with topical imiquimod (INN), a medication used to treat actinic keratoses, genital warts, or cervical dysplasia

Do not use tampons if you have cervical dysplasia. Avoid wearing tampons, as tampons can lead to vaginal irritation, or cervical dysplasia

Learn how to treat cervical dysplasia with diet, supplements, herbs

Next steps management

How to diagnose cervical dysplasia?

General clinical examination, and obtaining a careful history of symptoms, medical history, and a family history of cervical, ovarian, and uterine cancer

A pelvic ultrasound is a noninvasive procedure in which sound waves are used to make a picture of the organs and structures in the pelvis, it allows quick visualization of the female pelvic organs including the uterus, cervix, and vagina

How to test for cervical dysplasia?

Cervical cancer screening tests:

Your doctor will do a pelvic exam and may do a Pap test to detect any changes in cells on the cervix. If your Pap test result shows koilocytes or atypical glandular cells, your doctor may do a repeat Pap test. However, if the results of the repeat Pap test are still abnormal, you will need to have a test called colposcopy, a procedure used by physicians to diagnose cervical cancer, genital warts, etc.

A pap smear (papanicolaou smear, a Pap test) is a screening test for cervical cancer in which a sample of cells is scraped and collected from the surface of the cervix (ectocervix) and the cervical canal (endocervix) by using a small soft brush.

Separate diagnostic curettage of the uterine cavity (WFD) can be performed to diagnose the condition of the uterine mucosa, and for the detection of polyps, cervical dysplasia, etc.

A cold knife cone biopsy (conization) is a procedure used to look for cancerous cell proliferation in which a large cone of tissue is removed from the cervix by using a surgical or laser knife

 

Verified by: Dr.Diab (November 25, 2017)

Citation: Dr.Diab. (November 25, 2017). What is Cervical dysplasia? Causes Symptoms and Treatment. Medcoi Journal of Medicine, 7(2). urn:medcoi:article15725.