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
- What is cervical dysplasia?
- What causes cervical dysplasia?
- Are there symptoms of cervical dysplasia?
- How is cervical dysplasia diagnosed?
- How is cervical dysplasia classified?
- What are the 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?
- Cervical Dysplasia At A Glance
- Find a local Obstetrician-Gynecologist in your town
Are there symptoms or signs of cervical dysplasia?
Typically, cervical dysplasia does not produce any signs or symptoms. So regular screening is important for early diagnosis and treatment.
How is cervical dysplasia diagnosed?
Screening for cervical dysplasia
Cervical dysplasia and cervical cancer generally only develop over a period of years, so regular screening is essential to detect and treat early precancerous changes and prevent cervical cancer. Traditionally, the Papanicolaou test (Pap test or Pap smear) has been the screening method of choice. To perform the Pap smear, the health care practitioner removes a swab or brush sample of cells from the outside of the cervix during a pelvic examination using a speculum in the vagina for visualization. The cells are smeared onto a glass slide, stained, and observed under the microscope for any evidence of dysplasia or cancer.
Newer, liquid-based systems to screen samples of cervical cells are also available and are effective screening tools for detection of dysplasia. The samples for this test are removed as for the conventional Pap smear, but the sample is collected in a vial of liquid that is later used to prepare a microscope slide for examination as with the Pap smear.
For women whose initial screening result is unclear or abnormal, other diagnostic tests are used:
- Colposcopy is a gynecological procedure that illuminates and magnifies the
vulva, vaginal walls, and uterine cervix in order to detect and examine
abnormalities of these structures. A
colposcope is a microscope that resembles a
pair of binoculars. The instrument has a range of magnification lenses. It also
has color filters that allow the physician to detect tiny abnormal blood vessels
on the cervix. The colposcope is used to examine the vaginal walls and cervix
through the vaginal opening. Colposcopy is a safe procedure with no
complications other than mild vaginal spotting of blood.
- Biopsies are tissue samples obtained for examination under the microscope A
biopsy may be taken of suspicious areas seen during colposcopy.
- HPV testing to detect whether or not HPV infection with a "high-risk" HPV type is present may be recommended for some women. This may be particularly useful if the results from regular screening tests are ambiguous, such as results suggesting atypical squamous cells of uncertain significance or ASC-US (see below). Because of the number of women infected with HPV in general and because the infection can be temporary and short-lived, regular screening of all women for HPV infection is not thought to be useful and is not routinely performed in the U.S.
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