Cervical dysplasia

This page was reviewed under our medical and editorial policy by

Ruchi Garg, MD, Chair, Gynecologic Oncology, City of Hope Atlanta, Chicago and Phoenix

This page was reviewed on January 21, 2022.

The cervix is the lower portion of the uterus that connects to the vagina. Changes to the cells that line the cervix can be early precursors to cervical cancer, which happens when abnormal cells begin to grow and spread in an uncontrolled manner. Cervical dysplasia isn’t cancer, but treating it may help you prevent cervical cancer from developing in the future.

What is cervical dysplasia?

Precancerous cervical cell changes are referred to as cervical dysplasia, cervical intraepithelial neoplasia (CIN) and squamous intraepithelial lesion (SIL). All cervical cancers begin with these cellular changes, but not all women with cervical dysplasia will go on to develop cancer. In most cases, cervical dysplasia resolves on its own without treatment. In some instances cervical dysplasia must be treated.  The good news is treatment almost always prevents cervical cancer from forming.

After cervical cell samples are evaluated in a laboratory, cervical dysplasia is ranked from 1 to 3 on a scale of increasing severity, and the cervical dysplasia stages may be described as mild, moderate or severe.

  • CIN1 (mild dysplasia/low-grade SIL): The least severe type of dysplasia. Here, a small amount of tissue appears abnormal.
  • CIN2 or CIN3 (moderate to severe dysplasia/high-grade SIL): These precancers are more serious, with a greater amount of tissue appearing abnormal.

Cervical dysplasia causes

The most common cause of cervical dysplasia is the human papillomavirus. Also known as HPV, this is a prevalent sexually transmitted virus, spreading from person to person during skin-to-skin sexual contact. According to the Centers for Disease Control and Prevention (CDC), 91 percent of all cervical cancers are caused by HPV.

The CDC reports  that at least 80 percent of women will have had HPV by age 50. And the American Cancer Society notes that there are more than 150 strains of HPV—14 of which are known to cause cervical cancer.

Although most cases of HPV go away on their own within two years, sometimes your body’s immune system is unable to fight off the infection, and it causes cervical dysplasia. The most common type of cervical cancer-causing HPV is HPV 16, which accounts for about half of all cervical cancers caused by this virus. Others include HPV 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68.

Cervical dysplasia risk factors

Several risk factors may increase your odds of developing cervical dysplasia, including:

  • Smoking
  • Multiple sex partners
  • Human immunodeficiency virus (HIV)
  • Having sex before age 18
  • Giving birth before age 20
  • Immunosuppressant drugs for example status-post organ transplant
  • Maternal exposure to DES (diethylstilbestrol)
  • Three or more full-term pregnancies
  • Family history of cervical cancer
Not everyone with these risk factors will develop cervical dysplasia, but if you're experiencing them, it's a good idea to discuss them with your physician. That way, your provider is better able to tailor your screening frequency to your individual risk level.

Cervical dysplasia symptoms

Typically, there are no symptoms associated with cervical dysplasia, so it’s important to undergo regular Pap tests or cervical cancer screenings on a schedule recommended by your doctor so your care team can monitor for cervical dysplasia and look for signs of cervical cancer.

HPV testing will likely also be performed at this time. During a Pap test, your doctor will collect a sample—or smear—of cervical cells to be checked for abnormalities. If any are found, further testing may be recommended. Because cervical cancer is slow-growing, precancerous changes are usually caught early.

If dysplasia has advanced to cervical cancer, you may experience symptoms such as:

  • Abnormal bleeding
  • Vaginal discharge
  • Painful sex
  • Back and pelvic pain

Cervical dysplasia diagnosis

Abnormal changes to cervical cells may be detected through a Pap smear. Cells that are collected during a Pap test are viewed microscopically in order to determine if cervical dysplasia is present. Cellular changes to the cervix are characterized in the following ways:

  • LSIL, or low-grade squamous intraepithelial lesion
  • HSIL, or high-grade squamous intraepithelial lesion
  • Possibly malignant
  • AGC, or atypical glandular cells
  • ASC, or atypical squamous cells

In cases of mild dysplasia, your doctor will likely monitor with future Pap tests or may refer for further testing with colposcopy. If the dysplasia is more severe, usually colposcopy is recommended. During a colposcopy, an instrument called a colposcope is used to view the cells more closely, and a biopsy of the area of concern may be taken.

Dysplasia results from a biopsy are referred to as cervical intraepithelial neoplasia (CIN) and categorized as follows:

  • CIN1, mild dysplasia
  • CIN2, moderate to marked dysplasia
  • CIN3, severe dysplasia or carcinoma in situ

These terms can be a handful. Your doctor can help you understand what your results mean. Always ask questions. This can help you share decision-making with your care team.

Cervical dysplasia treatment

Most often, mild cervical dysplasia will go away on its own without treatment. However, in more severe cases, treatment may be recommended. Treatment for cervical dysplasia may consist of:

If you have cervical dysplasia, your doctor may recommend increasing the frequency of your Pap tests to monitor cellular changes. If any signs of cervical cancer are noted, it’s important to work with a gynecologic cancer specialist to plan out your treatment regimen.

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