
Cervical
Dysplasia
After
reading this article, 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 medical
laboratory 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 laboratory for testing.
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 fine-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. It can be done
by cutting the tissue out with a surgical knife, cautery (burning
tool), laser, or wire loop. The tissue removed is closely examined
in the lab to be sure there is no evidence of cancer.
After
having a cone biopsy, a few women have difficulty getting pregnant
or have miscarriages. 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, chick peas, chicken liver, oranges, brewer's yeast, and spinach.
To
lower your risk of cervical dysplasia, it is best to have just one
sexual partner.
Robert
B. McWilliams, MD
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