In most cases, cervical cancer is a slowprogressing disease that often takes years to develop.

Before actually developing into cancer, the cervix undergoes abnormal changes called cervical dysplasia. What is Cervical Dysplasia? Cervical dysplasia describes the mild to severe abnormal changes that can occur in the lining of the cervix. It is detected by a routine Pap smear. Although cervical dysplasia can lead to cervical cancer, it is in no way a cancer diagnosis. Pap smear findings are classified into several different categories: ASCUS (Atypical Cells of Undetermined Significance): An ASCUS pap smear result is considered to be mildly abnormal. This is the most common type of abnormal Pap smear. It basically means there were very mild changes and the cause could not be determined. The cause of the abnormal findings could be due to infection, irritation, or precancerous changes. ASCUS is not considered to be cervical dysplasia until further tests confirm it. AGUS (Atypical Glandular cells of Undetermined Significance): AGUS refers to glandular cells that may originate in the cervical canal or uterus. Although not technically cervical dysplasia, AGUS can indicate underlying serious conditions. AGUS results are considered rare, resulting in less than one percent of Pap smear results. LGSIL (Low Grade Squamous Intraepithelial Lesion): An LGSIL result means that mild dysplasia, more than likely caused by the human papillomavirus, has been detected. It is the most common classification of cervical dysplasia, and in most cases, clears up on its own within two years. HGSIL (High Grade Squamous Intraepithelial Lesion): HGSIL is a more serious classification of cervical dysplasia. If left untreated, it could lead to cervical cancer. An alternative grading method of classifying the degree of cervical dysplasia is by using the term CIN (cervical intraepithelial neoplasia). CIN identifies how much of the lining of the cervix is invaded by abnormal cells. CIN Classifications CIN I: Mild dysplasia; abnormal cells can be found in 1/3 of the lining of the cervix

CIN II: Moderate dysplasia; abnormal cells can be found in 2/3 of the lining of the cervix CIN III: Severe dysplasia; abnormal cells can be found in more than 2/3 of the lining of the cervix and up to the full thickness of the lining

It is important to note that cervical dysplasia is not cancer. It is a precancerous condition that when left untreated, could develop into cervical cancer. Symptoms of Cervical Dysplasia There are usually no symptoms experienced with cervical dyplasia. Dysplasia is initially detected through a Pap smear, thus the need to get regular Pap smears. Why Do Women Get Cervical Dysplasia? There is a strong link between abnormal cervical changes and HPV , the human papillomavirus. HPV is a common virus that most women will be infected with at some time in their life. The good news is that in most cases, HPV clears up on its own and will not cause any abnormal cervical changes. Other possible risk factors for developing cervical dysplasia are: smoking having multiple sexual partners pregnancy before the age of 20 suffering from conditions that affect the immune system, like HIV Treatment for Cervical Dysplasia If a Pap smear comes back abnormal, the next step is to have a colposcopy. A colposcopy is an in-office procedure that allows a doctor to examine the cervix more thoroughly. Depending on the findings, a cervical biopsy may be performed. Once cervical dysplasia is confirmed, treatment will vary, depending upon the severity. Mild to moderate cases of dysplasia often require no treatment. A "watch and wait" approach is often taken. With this type of treatment, a colposcopy/biopsy is normally done every six to 12 months to see if the dyplasia is clearing up on its own or progressing. More severe cases of dyplasia require medical treatment. Common treatments include a LEEP , conization, cryosurgery, and other surgical methods. Once treated, cervical dysplasia can return, so follow up is necessary. Cervical Dysplasia Surgery

Treatments for cervical dysplasia fall into two general categories: 1) destruction (ablation) of the abnormal area, and 2) removal (resection). Both types of treatment are equally effective. Generally, destruction (ablation) procedures are used for milder dysplasia and removal (resection) is recommended for more severe dysplasia or cancer. Destruction (ablation) The destruction (ablation) procedures for treatment of cervical dysplasia include carbon dioxide laser photoablation and cryocautery. These treatments use a laser or freezing methods to remove the abnormal cells. The most common complications of ablation procedures are narrowing (stenosis) of the cervical opening and bleeding. Disadvantages of this treatment include that this procedure does not allow sampling of the abnormal area and is not satisfactory for treating cervical cancer. Clear vaginal discharge and spotting of blood can occur for a few weeks after these procedures. Removal (resection) The removal (resection) procedures are loop electrosurgical excision procedure (LEEP), cold knife conization, and hysterectomy. Loop electrosurgical excision procedure, also known as LEEP, is an inexpensive, simple procedure that uses a radiofrequency current to remove abnormal areas. With this and other removal procedures, an intact tissue sample for analysis can be obtained. A cone biopsy is the surgical removal of abnormal areas using conventional surgical tools. Vaginal discharge and spotting commonly occur after these procedures. Hysterectomy, or the surgical removal of the uterus, is used to treat almost all cases of invasive cervical cancer and may sometimes be used to treat severe dysplasia or dysplasia that recurs after any of the other treatment procedures. Surgical procedures and complications LEEP procedures are usually performed with one of three loop sizes. The smaller the loop required to remove all the dysplasia, the less chance of surgical complications. In addition, increased experience of the doctor can improve your chances of escaping surgical complications. Perhaps the most frequent complication is just plain failure to cure the problem, and with each additional LEEP the chance of complications increases significantly. A cone biopsy is done with a knife to remove the cervical tissue next to, and deeper into, the cervical canal. LEEP and cone biopsy complications are relatively rare, but if they occur they can be disastrous. Usually your doctor will ask you to postpone pregnancy until one year after a LEEP

or cone biopsy so that the cervix can fully heal from the surgery. Nevertheless, cervical incompetence sometimes occurs, in less than 5% of cases, and makes it difficult to carry pregnancies to term (resulting in miscarriages) because the cervix is too thin to keep the uterus closed during the later stages of pregnancy. Infection can occur following a LEEP or cone biopsy. Pelvic discomfort during the procedure and cramping afterwards is common. A cone biopsy may remove more tissue than a LEEP and is generally used when dysplasia in the cervical canal is suspected to go beyond the reach of the LEEP. As far as complications from a LEEP are concerned, that is not as significant as the recurrence rate of cervical dysplasia. Stenosis, the most frequent complication, occurs in less than 5% of cases. Stenosis (shrinking of the cervical canal) can occur due to scarring. Stenosis is more common with a cone biopsy, however, because the cone biopsy does not allow for much control in respect to the incision depth and angle.

Cervical dysplasia Introduction: Cervical dysplasia is the abnormal growth of precancerous cells on the surface of the cervix. The condition is classified as low-grade or highgrade, 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. Signs and Symptoms: Cervical dysplasia often has no symptoms and is usually discovered during an annual Pap test. Occasional signs and symptoms of the condition can include: Genital warts Abnormal bleeding Spotting after intercourse Vaginal discharge Low back pain These symptoms can also be caused by other conditions. It's important to see your doctor for an accurate diagnosis. Causes: The precise cause of cervical dysplasia is not known. Studies have found a strong association between cervical dysplasia and infection with HPV. Risk Factors: The following may increase a person's risk for developing cervical dysplasia: Human papillomavirus (HPV) infection Genital warts Smoking Being sexually active at a younger age (younger than 18 years old) Giving birth before age 16 Having multiple sexual partners Having a partner whose former partner had cervical cancer History of one or more sexually transmitted diseases, such as genital herpes or HIV Having suppressed immune system, such as from HIV or chemotherapy to treat cancer Using birth control pills for longer than 5 years

Being born to a mother who took diethylstilbestrol (DES) to become pregnant or to sustain pregnancy. This drug was used many years ago to promote pregnancy but it is no longer used for these purposes. Low levels of folate (vitamin B9) in red blood cells Dietary deficiencies in vitamin A, betacarotene, selenium, vitamin E, and vitamin C (scientific data is not entirely conclusive at this time; see section on Nutrition and Dietary Supplements) Diagnosis: 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. Preventive Care: 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: Practicing safe sex Not smoking

Eating a diet rich in beta-carotene, vitamin C, and folate (vitamin B9) from fruits and vegetables. Cruciferous vegetables, such as cabbage, cauliflower, and broccoli, are especially important in preventing cancers such as cervical cancer. Treatment Approach: 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 Medications are not used to treat cervical dysplasia. Surgery and Other Procedures 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: Cryocauterization -- Cryocauterization uses extreme cold to destroy abnormal cervical tissue. This is the simplest and safest procedure, and it usually destroys 99% of the abnormal tissue. Cryocauterization is frequently performed without anesthesia. Laser therapy -- Lasers destroy abnormal cervical tissue with less scarring than cryocauterization. Lasers are more costly than cryocauterization, are performed with local anesthesia, and have a 90% cure rate. Loop electrosurgical excision (LEEP) -During a LEEP, a thin loop wire excises visible patches of abnormal cervical tissue. LEEP is performed with local anesthesia and has a 90% cure rate. Cervical conization -- During a cervical conization, a small cone-shaped sample of abnormal tissue is removed from the cervix. Cervical conization requires general anesthesia and has a 70 - 98% cure rate, depending on whether cancer cells have spread beyond the cervix.

Nutrition and Dietary Supplements 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. Eat calcium rich foods, including beans, almonds, and dark green leafy vegetables, such as spinach and kale. Eat more cruciferous vegetables, such as cabbage, broccoli, and cauliflower. Eat antioxidant rich foods, including fruits such as blueberries, cherries, and tomatoes, and vegetables such as squash and bell pepper. Avoid refined foods such as white breads, pastas, and sugar. Eat more lean meats, cold-water fish, or beans for protein. Use healthy oils, such as olive oil. Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine. Avoid caffeine, alcohol, and tobacco. Drink 6 - 8 glasses of filtered water daily. Exercise moderately, for 30 minutes daily, 5 days a week. 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: Beta-carotene 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 betacarotene 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: Omega-3 fatty acids, such as fish oil, 1 2 capsules or 1 tablespoonful oil daily, to help decrease inflammation and improve general health. Omega-3 fatty acids may increase the risk of bleeding, especially if you take blood-thinners such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. A multivitamin daily, containing the antioxidant vitamins A, C, D, E, the Bvitamins including folic acid, and trace minerals such as magnesium, calcium, zinc, and selenium. Indole-3-carbinol , a compound derived from cruciferous vegetables such as broccoli, Brussels sprouts, and cabbage. One study found that taking 200 mg or 400 mg of indole-3-carbinol helped treat cervical dysplasia, but more research is needed. Taking this compound as a supplement may interact with other medications, so ask your doctor before taking it to be safe. It is safe to eat vegetables that contain this compound. Herbs 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. Green tea (Camelia sinensis) extracts as an ointment or pill -- In one human study, an extract of green tea reduced cervical dysplasia caused by infection with the human papilloma virus (HPV). More research is needed. Green tea may interact with a number of medications, especially if the tea contains caffeine. To be safe, ask your doctor before taking green tea as a supplement. People with diabetes and liver disease should also ask their doctors before taking green tea. Turmeric (Curcuma longa) standardized extract, 300 mg 3 times a day, for inflammation. Turmeric may increase the risk of bleeding, especially if you also take blood-thinners such as

warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Pregnant women and people with gallstones or gallbladder disease should not take turmeric. Other Considerations: Pregnancy Cervical dysplasia may get worse during pregnancy, but treatment can generally be put off until after delivery. It's safe to do a biopsy to diagnose cervical dysplasia during pregnancy. Treatment with cervical conization may affect fertility. Prognosis and Complications 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 highgrade 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. Source: http://www.umm.edu/altmed/articles/cervicaldysplasia-000034.htm#ixzz2HFdlOCgq Follow us: @UMMC on Twitter | MedCenter on Facebook