Julianne M. Dunne, MD

Cervical dysplasia is the medical term for abnormal cells on the cervix.  Dysplasia is caused by Human Papillomavirus (HPV) and can lead to cervical cancer, if it progresses and is not treated.  Dysplasia is NOT cancer and most cases of dysplasia go away on their own with no treatment.  However, all women diagnosed with cervical cancer started with a precancerous condition.

Dysplasia is reported in different severities based on how it appears with microscopic evaluation. It may be mild, moderate or severe.  The terminology used by pathologists to categorize dysplasia is called “cervical intraepithelial neoplasia” or CIN.  It is based on the proportion of cells that are abnormal.

Moderate dysplasia or CIN 2 contains at least two-thirds abnormal cells.

If the cells are categorized as severe dysplasia or CIN 3 then almost all the cervical cells look abnormal.  About 1 in four women will develop either CIN 2 or 3 during their lifetime.  Dysplasia may also be referred to as an “intraepithelial lesion”. Mild dysplasia is referred to as a low-grade intraepithelial lesion or LSIL and moderate and severe dysplasia are both referred to as high-grade intraepithelial lesions or HSIL.


How does a woman get cervical dysplasia?

Cervical dysplasia is caused by Human Papillomavirus (or HPV) which is a sexually transmitted virus.  It is spread through any intimate, genital skin to skin contact with a sexual partner.  Condoms are protective but only protect the areas that are covered.


Are certain women at higher risk than other women for developing cervical dysplasia?

Yes, there are certain risk factors that may increase the chance that an HPV infection develops into dysplasia and possibly cervical cancer.
• Smoking, which interferes with the body’s ability to fight off infection, can double the risk that abnormal cells develop into CIN 3.
• Infection with other STDs particularly herpes simplex virus (HSV) or Chlamydia
• Health conditions that weaken the immune system particularly HIV/AIDS
• In-utero exposure to DES, a drug some women took prior to the 1970’s to prevent miscarriage.
• A first degree relative (such as mother or sister) with a history of cervical cancer
• Deficient levels of folic acid


What are the symptoms of cervical dysplasia?

There are NO symptoms when the changes of the cervix are at a precancerous stage.  This is why routine screening with Pap smears is important.


How is cervical dysplasia diagnosed?

Dysplasia is screened for with routine Pap smears and, if you are over 30, with an additional test for HPV.  If the Pap smear result is abnormal or if there is a persistent HPV infection, then a colposcopy will be recommended.  Colposcopy is an evaluation of the cervix done with magnification since cervical dysplasia cannot be seen with the “naked eye”.  Acetic acid (vinegar) is applied to the cervix.  This will dehydrate the cells and the areas that are most suspicious will turn a whitish color and the most suspicious areas will be biopsied by your doctor.  Other suspicious aspects may be abnormal appearing blood vessels.  The biopsies are then correlated with the Pap smear results and your doctor will discuss treatment options with you.