Severe dysplasia is the most serious form of cervical dysplasia. It’s not cancer, but it has the potential to become cancer.
It doesn’t usually cause symptoms, so it’s almost always discovered during routine screening. If you’ve received a diagnosis of severe dysplasia, there are several very effective ways to treat it.
Keep reading to learn what a diagnosis of severe dysplasia means, what causes it, and what you can expect from treatment.
If you have severe cervical dysplasia, it means that severely abnormal cells have been found on your cervix. You don’t have cancer, and it doesn’t necessarily mean you’ll develop cancer. Rather, it’s a precancerous condition.
Cervical dysplasia is also known as cervical intraepithelial neoplasia (CIN). There are three categories of CIN:
- CIN 1 is mild or low-grade dysplasia. It should be monitored but often clears up on its own.
- CIN 2 is moderate dysplasia.
- CIN 3 is severe or high-grade dysplasia.
CIN 2 and CIN 3 may be reported as CIN 2-3 and considered precancerous.
Your doctor is likely to recommend treatment for severe dysplasia. The goal is to remove the abnormal cells, which lowers the risk of developing cancer. There are several ways to remove the abnormal tissue. These surgical procedures can often be done on an outpatient basis.
Loop electrosurgical excision procedure (LEEP)
LEEP is performed in the same manner as a pelvic exam, right in your doctor’s office. There’s usually no need for general anesthesia.
The procedure involves a small, electrically charged wire loop that cuts abnormal tissue away from the cervix. Then the area may be cauterized to prevent bleeding. From beginning to end, it should take about 30 minutes.
Once the tissue is removed, it can be sent to a lab to test for cancer cells.
You’ll be advised to avoid strenuous activity for about 48 hours and intercourse for up to 4 weeks. During this time, also avoid:
- sitting in a bath
Cold knife conization
Cold knife conization is a surgical procedure that requires regional or general anesthesia. Using a scalpel, your surgeon will remove a cone-shaped piece of cervical tissue. Later, a pathologist will examine it for signs of cancer.
For up to 6 weeks following the procedure, avoid:
If other procedures don’t work and tests show persistent dysplasia, hysterectomy may be an option. This procedure involves removing the cervix and uterus. It can be done abdominally, laparoscopically, or vaginally.
Pap and HPV testing
With treatment, most women won’t develop cervical cancer.
Although the exact cause can’t always be determined, the vast majority of cervical dysplasia cases are associated with HPV, the human papillomavirus. Almost
There are many strains of HPV. Low-risk types cause genital warts but don’t cause cancer. At least a dozen high-risk types can lead to cervical cancer.
Dysplasia occurs in the area of the cervix called the transformation zone. That’s where glandular cells change into squamous cells. It’s a normal process, but it makes this area more vulnerable to HPV.
There are usually no symptoms associated with cervical dysplasia, so you probably won’t know you have it until you have a Pap smear.
Mild cervical dysplasia doesn’t always require treatment because it can go away on its own. But monitoring mild dysplasia is important since it can progress to moderate or severe dysplasia.
Cervical dysplasia, even severe dysplasia, doesn’t usually cause symptoms. Doctors typically discover it when a routine Pap smear comes back with abnormal results.
Dysplasia is typically detected with a Pap smear. Abnormal results don’t always mean you have dysplasia, though.
Some abnormal changes are due to oral contraceptives, or even problems with the sample. If the changes appear mild, your doctor may want to wait and repeat the test in a few months.
If the cells appear very abnormal, you may need colposcopy-directed biopsy. This procedure can take place right in your doctor’s office, without anesthesia.
With the assistance of a speculum and special highlighting solutions, your doctor uses the colposcope to magnify, view, and photograph the cervix.
At the same time, your doctor will remove a tissue sample. They’ll send it to a lab for examination under a microscope.
Aside from CIN 3, here are some terms you may find on your Pap smear or biopsy report:
- Squamous intraepithelial lesion (SIL). Squamous is a type of cell in the tissue covering the cervix. SIL is used to describe Pap smear results, but it’s not a diagnosis.
- Atypical squamous cells of undetermined significance (ASCUS). This is the most common result on a Pap smear. It means there are changes to cervical cells, usually the result of HPV infection, but can include other factors.
- Atypical squamous cells, cannot exclude HSIL (ASCH). There are changes to cervical squamous cells that may raise concerns of precancer or cancer.
- Atypical glandular cells (AGC) or atypical glandular cells of undetermined significance (AGUS). Glandular cells are a type of cell in the tissue covering the inner canal of the cervix as well other parts of the female reproductive system. Changes to these cells can raise concerns of precancer or cancer.
- Low-grade SIL (LSIL). Squamous cells are mildly abnormal. It’s typically due to HPV infection and can clear up on its own. LSIL compares to CIN 1.
- High-grade SIL (HSIL). There are serious changes to cervical squamous cells. It’s more likely to be associated with precancer or cancer. HSIL compares to CIN 2 and CIN 3.
- Adenocarcinoma in situ (AIS) or carcinoma in situ (CIS). Severely abnormal cells are found in cervical tissue. It hasn’t yet spread and is considered a precancerous condition.
The main risk factor of dysplasia is HPV infection. Other things that may increase risk are:
- history of sexually transmitted infections (STIs)
- being sexually active before age 18
- giving birth before age 16
- multiple sex partners
- weakened immune system
- exposure to a hormonal drug called diethylstilbestrol (DES)
One way to lower the chances of getting severe dysplasia is to have regular Pap smears, which can identify dysplasia in an earlier stage. This will allow closer monitoring and treatment, if it doesn’t go away on its own.
How often you should be tested depends on your age and health history. Your doctor can tell you how often to get screened.
According to the
The HPV vaccine protects against the most common strains of HPV. It’s more effective in those who haven’t started having sex.
The CDC recommends the HPV vaccine at age 11 or 12, or for everyone up to age 26 who hasn’t already been vaccinated. It can even be used as early as age 9.
The HPV vaccine is also
Severe cervical dysplasia isn’t cancer, but it has the potential to turn into cancer. Treatment for severe cervical dysplasia is generally safe and effective and can prevent you from developing cancer.