Risk Factors for Cervical Dysplasia
Persistent HPV infection is the most important risk factor for cervical dysplasia, especially moderate-to-severe cervical dysplasia.
In women, an increased risk of a persistent HPV infection is associated with:
- Early initiation of sexual activity.
- Having multiple sex partners.
- Having a partner who has had multiple sex partners.
- Having sex with an uncircumcised man.
Diagnosis of Cervical Dysplasia
Because a pelvic exam is usually normal in women with cervical dysplasia, a Pap test is necessary to diagnose the condition.
Although a Pap test alone can identify mild, moderate, or severe cervical dysplasia, further tests are often required to determine appropriate follow-up and treatment. These include:
- Repeat Pap tests.
- Colposcopy, a magnified exam of the cervix to detect abnormal cells so that biopsies can be taken.
- Endocervical curettage, a procedure to check for abnormal cells in the cervical canal.
- Cone biopsy or loop electrosurgical excision procedure (LEEP), which are performed to rule out invasive cancer. During a cone biopsy, the doctor removes a cone-shaped piece of tissue for lab examination. During LEEP, the doctor cuts out abnormal tissue with a thin, low-voltage electrified wire loop.
- HPV DNA test, which can identify the HPV strains which are known to cause cervical cancer.
Treatments for Cervical Dysplasia
The treatment of cervical dysplasia depends on many different factors, including the severity of the condition and the age of the patient. For mild cervical dysplasia, often only continued monitoring with repeat Pap tests is needed for women ages 20 and younger. For older women with mild cervical dysplasia, usually no treatment is needed unless mild cervical dysplasia has persisted for two years, progressed to moderate or severe cervical dysplasia, or there are other medical problems.
Treatments for cervical dysplasia include two of the procedures also used for diagnosis: cone biopsy or LEEP.
Other treatments include:
- Cryosurgery (freezing)
- Laser surgery
- Traditional surgery
Because all forms of treatment are associated with risks such as heavy bleeding and possible complications affecting pregnancy, it's important for patients to discuss these risks with their doctor prior to treatment. After treatment, all patients require follow-up testing, which may involve repeat Pap tests in six and 12 months or an HPV DNA test. After follow-up, regular Pap tests are necessary.