Cervical Dysplasia

What is cervical dysplasia?

Abnormal, or precancerous, cells in and around the cervix indicate cervical dysplasia. Your vagina opens up into your cervix, which is the lower part of your uterus. Your cervix contracts and expands during labor to allow the baby to pass through.

Cervical dysplasia is detected in a pap test (pap smear), and diagnosed in a biopsy. Abnormal changes in cells can be mild, moderate, or severe. The presence of cervical dysplasia does not mean you have cervical cancer.

Symptoms of cervical dysplasia

People with cervical dysplasia do not usually have any symptoms. This is why it’s important to get screened regularly. The American Academy of Family Physicians (AAFP) recommends routine pap tests to diagnose cervical cancer early. You can check AAFP’s clinical guidelines to see when and how often you should be tested.

What causes cervical dysplasia?

The cells on your cervix can change over time. This means that you can develop cervical dysplasia at almost any age.

Human papillomavirus (HPV) is the primary cause of cervical dysplasia. According to the National Cancer Institute, there are more than 200 different HPV viruses. Over 40 of these are spread through sexual contact. Most viruses are low-risk for cancer and about a dozen are high-risk. In the United States, HPV is the most common sexually transmitted infection.

The presence of cervical dysplasia and/or HPV does not indicate cervical cancer. However, precancerous cells can become cancerous. High-risk HPV types 16 and 18 cause about 70 percent of cervical cancer.

There are several factors that can increase your risk of cervical dysplasia:

  • Becoming sexually active before age 18.
  • High number of sexual partners.
  • Having illnesses or using medicines that lower your immune system.
  • Smoking or chewing tobacco.
  • Not using condoms. While condoms help prevent HPV, they do not fully protect you.
  • Giving birth before age 16.

How is cervical dysplasia diagnosed?

Cervical dysplasia is typically detected during a routine pap test. For this test, your doctor will swab your cervix to collect a sample of cells. This is generally not painful. It can take up to 3 weeks for the lab to process the test.

The pap test results can be normal, abnormal, or inconclusive. If normal, you should follow AAFP’s recommendation for regular pap tests.

An abnormal result is known as cervical dysplasia. Additional testing is needed to see if the cell changes are mild, moderate, or severe. A colposcopy is an in-office procedure that gives your doctor a closer look at your cervix. They will gather a larger sample of abnormal tissue, or cells, to biopsy. The precancerous cells are classified as:

  • Low-grade SIL (SLIL) or CIN1 indicates mild abnormality.
  • High-grade SIL (HSIL), CIN2, or CIN3 indicates moderate to severe abnormality.

An HPV test can be completed at the same time or separately. It will identify the presence and type of HPV.

Inconclusive results do not indicate cervical dysplasia. You could have a simple infection in your cervix or vagina. For inconclusive or abnormal results, further action or diagnoses will depend on your age and medical history. Your doctor may order more frequent screening, a repeat pap, or additional tests.

Can cervical dysplasia be prevented or avoided?

There are three HPV vaccines approved by the U.S. Food and Drug Administration (FDA). These are Gardasil®, Gardasil® 9, and Cervarix®. Girls and boys between the ages of 9 and 26 should get vaccinated before becoming sexually active. The HPV vaccine is proven to lower your risk of HPV. It does not fully prevent cervical dysplasia. Consult your doctor to know if you meet all criteria for the vaccine.

Cervical dysplasia treatment

Treatment for cervical dysplasia will depend on the degree of abnormal cells and your medical history. Most mild cases will clear up naturally. Your doctor may suggest annual pap tests, instead of every 3 to 5 years.

Instances of moderate or severe cervical dysplasia could require immediate treatment. Options include:

  • Cryosurgery to freeze off the abnormal cervical tissue.
  • LEEP (loop electrosurgical excision procedure) to burn off the abnormal cells with an electric looped wire.
  • Surgery to remove the abnormal cells with a laser, scalpel, or both.

Rare cases of severe cervical dysplasia may require a hysterectomy to fully remove the cervix.

Living with cervical dysplasia

Early diagnosis and prompt treatment cures most cases of cervical dysplasia, according to MedlinePlus. Follow your doctor and AAFP’s screening recommendation for early detection.

Once treated, cervical dysplasia can return. People who have severe cervical dysplasia, high-risk HPV, or whose condition goes untreated could develop cervical cancer.

Questions to ask your doctor

  • Is cervical dysplasia or HPV hereditary?
  • Does cervical dysplasia or HPV affect my chances of getting pregnant?
  • Is there an HPV test for men?
  • If my partner tested positive for HPV, can he or she give it to me? What about same-sex partners?