Cervical dysplasia is the growth of abnormal precancerous cells on the cervix, almost always caused by persistent infection with high-risk human papillomavirus (HPV). Most mild changes clear on their own, while higher-grade lesions are treated to prevent cervical cancer.
Key symptoms
- Usually no symptoms; found on routine screening
- Bleeding after sex in some patients
- Risk factors: smoking, many partners, weakened immune system
- Worry about an abnormal test result
What you find on exam
- Speculum exam often normal
- Cervix may look red or bleed easily on contact
- Look for visible lesions or warts on the cervix and vulva
- Bimanual exam to rule out other pelvic findings
Tests
- Pap test (cytology) and HPV testing based on age
- Colposcopy with acetic acid to find abnormal areas
- Cervical biopsy to grade the lesion (CIN 1, 2 or 3)
- Pregnancy test before treatment
Treatment basics
- CIN 1: repeat testing, since most cases clear without treatment
- CIN 2 or 3: excision with LEEP or cone biopsy
- Ablation with cryotherapy in selected cases
- HPV vaccination through age 26, and shared decision up to age 45
- Smoking cessation and close follow-up
Red flags
- Visible cervical mass or ulcer
- Heavy bleeding after sex or between periods
- Pelvic pain or weight loss suggesting invasive cancer
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.