Cervical cancer was once the leading cause of cancer death in women, according to the Centers for Disease Control and Prevention. It has decreased over the past 40 years, primarily because of the prevalence of cervical cell testing, known as the Pap test. Pap tests diagnose cervical dysplasia, the presence of abnormal cells on the surface of the cervix, before the cells can turn cancerous or invade deeper tissue.
Causes
Almost all cervical dysplasia is caused by human papilloma virus, or HPV, Medline Plus states. A number of strains of the sexually transmitted virus, which affects most adults at some point in their lives, can infect the cervix. Most HPV infections clear up spontaneously, but some strains cause cervical dysplasia. Other factors that increase the risk of cervical dysplasia include having many sexual partners, having sex before age 18, smoking, giving birth before age 16 and having a suppressed immune system.
Procedure
Cervical dysplasia is diagnosed by scraping a few cells from the surface of the cervix during a vaginal speculum exam, a procedure known as a Pap test. A speculum holds the vagina open so the doctor can inspect the cervix and obtain the cells. The cells are then sent to a laboratory for microscopic examination for changes.
Classifications
Cervical dysplasia is classified according to the location of the abnormalities. Normal surface cells on the cervix follow an organized pattern. In cervical dysplasia, the appearance of the cells changes. Cervical dysplasia is designated as cervical intraepithelial neoplasia, or CIN. Mild dysplasia, or CIN I, shows only a few abnormal cells, according to gynecologist Paul Indman, M.D. of Advanced Gynecology Solutions in San Jose, California. In moderate cervical dysplasia, or CIN II, the abnormal cells extend about halfway through the top layer of the surface of the cervix. Severe dysplasia, also called CIN III or carcinoma-in-situ, means that all the cells in the top layer of the surface of the cervix appear abnormal, but no abnormal cells have spread beyond the surface.
Biopsy
A diagnosis of cervical dysplasia warrants further examination of the cells of the cervix. Colposcopy, an office procedure, allows the physician to look more closely at suspicious cells and take a biopsy, a sample of abnormal-looking tissue. Since the cervix has no nerve endings, colposcopy causes pressure but no pain. Cells removed from the lower part of the vagina may cause some discomfort and may require numbing, MayoClinic.com states.
Prognosis
Mild cervical dysplasia heals on its own in 70 percent of cases, Healthcommunities.com reports, while moderate and severe dysplasia have less chance of regressing on their own and more likelihood of turning cancerous. Since it takes up to 10 years for cervical dysplasia to turn into cancer, regular Pap tests and treatment to remove abnormal cells can prevent cervical cancer from developing. Treatment for moderate to severe dysplasia or mild dysplasia that does not go away may include cryosurgery, electrocauterization, laser vaporization or surgery to remove the abnormal tissue.
