Cervical dysplasia is the abnormal growth of precancerous cells on the surface of the cervix. The condition is classified as low-grade or high-grade, depending on the extent of the abnormal cell growth. Low-grade cervical dysplasia progresses very slowly and often gets better on its own. High-grade cervical dysplasia can lead to cervical cancer. Without treatment, 30 - 50% of cases of severe cervical dysplasia progress to invasive cancer. The risk of cancer is lower for mild dysplasia.
Cervical dysplasia is associated with the human papillomavirus (HPV), a sexually transmitted virus. A vaccine is available to protect against HPV, and regular Pap tests can usually find cervical dysplasia and treat it in its earl stage. Currently, 11% of U.S. women report that they do not have regular Pap tests.
Cervical dysplasia often has no symptoms and is usually discovered during an annual Pap test.
Occasional signs and symptoms of the condition can include:
These symptoms can also be caused by other conditions. It's important to see your doctor for an accurate diagnosis.
The precise cause of cervical dysplasia is not known. Studies have found a strong association between cervical dysplasia and infection with HPV.
The following may increase a person's risk for developing cervical dysplasia:
If you have any of the symptoms mentioned earlier, your doctor will perform a physical, including an abdominal, back, and pelvic examination. The doctor will also do a Pap test to detect precancerous or cancerous cells in the cervix. A Pap test is also done annually for screening purposes even when no symptoms are present. Depending on your history, a Pap test may be done more or less often. If there are any questionable or unclear results from the Pap smear, a gynecologist will do one of the following tests:
Colposcopy -- a procedure where the doctor uses a viewing tube with a magnifying lens to examine the abnormal cell growth in the cervix.
Biopsy -- a small sample of tissue is removed from the cervix and examined under a microscope for any signs of cancer.
While there is no sure way to prevent cervical dysplasia, regular Pap smears are the most effective way to identify it in its early stages and preventing it from progressing to cervical cancer. Women should begin getting annual Pap smears as soon as they become sexually active or no later than age 21. Women whose mothers took DES during pregnancy are advised to begin regular Pap smears at age 14, at the onset of their first menstrual period, or as soon as they become sexually active, whichever comes first.
Barrier contraceptives, such as condoms, may offer some degree of protection from cervical dysplasia.
Girls as young as 9 and women as old as 26 can get the HPV vaccine (Cervarix, Gardasil) that protects against HPV, the most common cause of cervical cancer. The vaccine is also approved for boys and young men, ages 9 - 26. Although the vaccine could prevent up to 70% of cervical cancer cases, it cannot prevent infection with every virus that causes cervical cancer. Routine Pap tests to screen for cervical cancer remain very important.
Some lifestyle modifications may also help prevent the development of cervical dysplasia:
An important consideration in deciding whether or not to treat cervical dysplasia is how the treatment may affect future fertility. There are no good studies investigating infertility after treatment for cervical dysplasia, but there is some evidence of increased risk of preterm delivery among pregnant women.
Surgical removal of abnormal tissue is still the treatment of choice for cervical dysplasia. Medications are not used to treat cervical dysplasia, and few complementary or alternative therapies have been evaluated for their effectiveness in treating the condition. Several studies indicate, however, that the development and progression of cervical dysplasia may be related to certain nutritional deficiencies, including folate, beta-carotene, and vitamin C.
Medications are not used to treat cervical dysplasia.
Surgical removal of abnormal tissue is the most common method of treating cervical dysplasia. Ninety percent of these procedures can be done in an outpatient setting. These procedures include:
Following these nutritional tips may help reduce the chances of developing cervical dysplasia. However, if you have cervical dysplasia you should ask your doctor before making any changes to your diet or taking any supplements. Some nutrients can interfere with certain medications and procedures.
Several population-based studies suggest that eating a diet rich in the following nutrients from fruits and vegetables may protect against the development of cervical cancer:
Some controversial clinical studies suggest that people who are deficient in beta-carotene may be more likely to develop cancerous or precancerous cervical lesions, but the research isn't clear. Other studies suggest that taking a beta-carotene supplement may help reduce the signs of cervical dysplasia. Despite these promising results, there is no proof that using beta-carotene supplements to prevent cervical dysplasia is effective.
Some researchers think that supplemental beta-carotene may increase the risk of lung cancer, prostate cancer, intracerebral hemorrhage, and cardiovascular and total mortality in people who smoke cigarettes or have a history of high-level exposure to asbestos. Beta-carotene from foods does not seem to have this risk. Beta carotene can interfere with some statin drugs.
Folate (Vitamin B9)
Like beta-carotene, some evidence suggests that folate, also known as vitamin B9, deficiencies may contribute to the development of cancerous or precancerous lesions in the cervix. Some researchers also think that eating foods with folate may improve the cellular changes seen in cervical dysplasia by lowering homocysteine levels. Homocysteine is a substance believed to contribute to the severity of cervical dysplasia. There is no clear proof, however, that eating more folate in your diet can help prevent or treat cervical dysplasia.
Ask your doctor if you would benefit from these supplements:
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner.
If you have cervical dysplasia, ask your doctor before taking any herb.
Pap smears are essential to detecting precancerous lesions as well as early stages of cervical cancer. Despite their value, they are not always 100% accurate. Up to 2% of women with normal Pap smear results actually have high-grade cervical dysplasia at the time of evaluation. In some rare cases, Pap smears may produce "false positive" results, meaning that a healthy woman may be falsely diagnosed with cervical dysplasia. Despite these errors, Pap smears are the most effective and reliable method of identifying cervical dysplasia.
With early identification, treatment, and consistent follow-up, nearly all cases of cervical dysplasia can be cured. Without treatment, many cervical dysplasia cases progress to cancer. Women who have been treated for cervical dysplasia have a lifetime risk for recurrence and malignancy. Fortunately, while the numbers of cervical dysplasia has been on the rise, the numbers of cervical cancer have declined dramatically. This may be due to better screening techniques, which identify cases of cervical dysplasia in the early stages.
Cancer - cervical; Cervical cancer; Pap smear - abnormal
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