Cervical Dysplasia (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Cervical dysplasia facts
- What is cervical dysplasia?
- What causes cervical dysplasia?
- Are there signs and symptoms of cervical dysplasia?
- How is cervical dysplasia diagnosed?
- How is cervical dysplasia classified?
- What are treatments for cervical dysplasia?
- Carbon dioxide laser photoablation
- Loop electrosurgical excision procedure (LEEP)
- Cold knife cone biopsy (conization)
- What is the prognosis (outlook) for cervical dysplasia?
- Can cervical dysplasia be prevented?
- Find a local Obstetrician-Gynecologist in your town
What causes cervical dysplasia?
Cervical dysplasia is caused by infection of the cervix with the human papillomavirus (HPV). Although there are over 100 HPV types, a subgroup of HPVs have been found to infect the lining cells of the genital tract in women. HPV is a very common infection and is transmitted most often through sexual contact; 80% of sexually active women will acquire the virus during their lifetimes. It is believed that over 14 million people become infected with HPV every year in the US, and approximately 50% of those infected are between the ages of 15 and 25. Most infections occur in young women, do not produce symptoms, and resolve spontaneously without any long-term consequences. The average length of new HPV infections in young women is 8-13 months. However, it is possible to become re-infected with a different HPV type.
Some HPV infections persist over time rather than resolve, and the reason why the infection persists in these women is not fully understood. Factors that may influence persistence of the infection include:
- advancing age,
- duration of the infection, and
- being infected with a "high-risk" HPV type (see below).
Persistent HPV infection has been shown to play a causal role in the development of genital warts and precancerous changes (dysplasia) of the uterine cervix as well as cervical cancer. Even though HPV infection appears to be necessary for the development of cervical dysplasia and cancer, not all women who have HPV infection develop dysplasia or cancer of the cervix. Additional, yet uncharacterized, factors must also be important in causing cervical dysplasia and cancer. Since HPV infections are transmitted primarily by sexual intimacy, the risk of infection increases as the number of sexual partners increases.
Among the HPVs that infect the genital tract, certain types typically cause warts or mild dysplasia ("low-risk" types; HPV-6, HPV-11), while other types (known as "high-risk" HPV types) are more strongly associated with severe dysplasia and cervical cancer (HPV-16, HPV-18). Cigarette smoking and suppression of the immune system (such as with concurrent HIV infection) have been shown to increase the risk for HPV-induced dysplasia and cancer of the cervix.
The HPV types that cause cervical cancer also have been linked with both anal and penile cancer in men as well as a subgroup of head and neck cancers in both women and men.
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