Carcinoma in situ (CIS) is a general term for an early stage cancer. Cervical carcinoma in situ is also referred to as stage 0 cervical cancer. It’s noninvasive, which means the cancerous cells are confined to the surface of your cervix and haven’t penetrated more deeply into the tissues.
The cervix is the narrow, lower part of the uterus. It’s the passageway from the uterus to the vaginal canal. Cervical cancer begins on the surface of the cervix and tends to grow slowly. It’s caused by several different strains of the human papillomavirus virus (HPV), which are spread by sexual contact.
According to the Centers for Disease Control and Prevention (CDC), over 12,000 women in the United States were diagnosed with cervical cancer in 2012. Most of these women were younger than 55. Cervical cancer is rare in women under 20 years old. It used to be the leading cause of cancer among women, but cases of it have decreased over the last 40 years.
Cervical cancer typically doesn’t cause symptoms until its later stages, so you may not have any symptoms with cervical CIS. That’s why having regular Pap smears are important for catching any abnormal cell changes early.
HPV is the main risk factor for developing cervical CIS. There are hundreds of strains of HPV, which are divided up into either low risk or high risk. There are 10 high-risk strains that are associated with abnormal cell changes in the cervix that can lead to cancer, but two of the strains (HPV 16 and HPV 18) are responsible for 70 percent of cases of cervical cancer.
Other risk factors may also play a role in the development of cervical CIS including:
- having multiple sexual partners
- smoking cigarettes
- having a weakened immune system
- having sexual intercourse at an early age
- having a diet low in fruits and vegetables
- using birth control pills for an extended period
- being infected with chlamydia
A Pap smear can collect abnormal cells that are then identified in a lab. An HPV test may be performed on the sample to check for the virus and to see whether high-risk or low-risk strains are present.
A colposcopy is an in-office procedure that allows your doctor to view your cervix with a special magnifying tool called a colposcope. Your doctor will apply a solution to the surface of your cervix to show any abnormal cells. They can then take a small piece of tissue called a biopsy. They’ll send this to a lab for a more definitive diagnosis.
If the biopsy shows CIS, your doctor might want to remove a larger piece of your cervix. If they remove the area with abnormal cells, they’ll also remove a surrounding margin of healthy tissue.
The treatment for cervical CIS is similar to that for cervical dysplasia. Although it’s called carcinoma in situ, it’s often treated like a precancerous growth because it’s not invasive.
Possible treatments include the following:
- A hysterectomy is an option for women who don’t want to preserve their fertility.
- Cryosurgery, or freezing the abnormal cells, can be done in your doctor’s office.
- Laser surgery or loop electrosurgical excision procedure are surgical options that are done on an outpatient basis. They involve removing the abnormal tissue with lasers or an electrically charged wire loop.
- Conization, another outpatient procedure, is used less often. It involves removing a larger, cone-sized piece of the cervix to ensure removal of the entire abnormal area.
Talk with your doctor about your treatment options to find the best one for you. Your treatment will depend on your age, desire to preserve your fertility, general health, and other risk factors.
After you have treatment for cervical CIS, your doctor will want to see you for follow-up visits and Pap smears every three to six months. Cervical cancer can come back, but regular Pap smears and checkups will allow your doctor to catch and treat abnormal cells early.
Your doctor will also address any concerns you may have about your cervical health.
Having cervical CIS can be emotionally trying, especially if you’re concerned about your fertility. Talk with your doctor about any support groups or finding a counselor if you need extra support.