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After reading this handout, you will know what cervical dysplasia is and what can cause it. You will also find out what measures your health care provider may take to diagnose and treat it.

What is cervical dysplasia?

Cervical dysplasia (also referred to as cervical intraepithelial neoplasia, or CIN) is an abnormal development of tissue growth in the cervix. The cervix is the narrow, lower portion of the uterus. Any woman who is or has been sexually active may have cervical dysplasia.

Dysplasia is not cancer, but it can develop into cancer of the cervix. Cervical dysplasia is classified as either mild, moderate, or severe.

How does it occur?

Cervical dysplasia has been linked to a sexually transmitted disease caused by a wart virus called human papillomavirus (HPV). It is more common in women who have had many sex partners or began to have intercourse before age 18. In addition, cervical dysplasia has been associated with cigarette smoking and too little folic acid in the diet.

What are the symptoms?

Cervical dysplasia seldom has any symptoms.

How is it diagnosed?

Cervical dysplasia is diagnosed by a simple, painless test called a Pap smear. To perform a Pap smear, your health care provider swabs your cervix and cervical canal with a long cotton swab, brush, or wooden scraper. Cells collected from the cervix with the swab are sent to a lab to be viewed under a microscope. The Pap smear can be done in your health care provider's office, clinic, or hospital.

A trained specialist may use a colposcope (an instrument with a magnifying lens) to look closely at the cervix. During the colposcopy small samples of any tissue that appears abnormal may be removed and sent to the lab for tests.

What is the treatment?

Mild cervical dysplasia often goes away without treatment. Beta-carotene taken orally is currently being studied as a treatment for mild cervical dysplasia. If mild dysplasia is not treated, another Pap smear should be done in 4 to 6 months. If the Pap smear still shows mild dysplasia, a colposcopic exam should be done.

For moderate dysplasia, your health care provider may freeze, burn, or use a laser to destroy the abnormal cells. The abnormal cells can also be cut out using a thin wire loop attached to an electrosurgical machine. This is called the loop electrosurgical excisional procedure (LEEP). You do not have to stay in the hospital for any of these procedures. They can be done in your provider's office.

For severe dysplasia, your health care provider will do a cone biopsy, which is the removal of a cone-shaped piece of the cervix. This removes all the tissue containing abnormal cells. Your provider can cut the tissue out with a surgical knife, cautery (burning tool), laser, or wire loop. The tissue removed is closely examined in the lab to look for any evidence of cancer.

Very few women have trouble getting pregnant or have miscarriages after a cone biopsy. If you become pregnant and have had a cone biopsy, tell your prenatal care provider about it. With special care and attention, most women who have had a cone biopsy are able to become pregnant and carry the baby to term.

How can I take care of myself?

After treatment for cervical dysplasia, you should have a Pap smear twice a year for the next 2 years, and once a year thereafter. Regular Pap smears allow your health care provider to detect any recurrence of the dysplasia and treat it promptly.

If you smoke, stop. Avoid breathing smoke from other people's cigarettes. Also, try to eat foods that contain folic acid. These include black-eyed peas, chickpeas, chicken liver, oranges, brewer's yeast, and spinach.

How can I help prevent cervical dysplasia?

To lower your risk of cervical dysplasia:

• Have just one sexual partner.
• Avoid sexual intercourse until you are 18 or older.