Stages of cervical dysplasia

The diagnosis of invasive cancer usually is made by biopsy of a visible lesion on pelvic examination. If a Pap test reveals abnormal cell changes, the next step may include a colposcopy and biopsy to determine
the extent of the abnormality. The course of treatment depends on the stage of the disease.

Disease of the cervix can range from mild dysplasia (CEST I), also known as low-grade squamous intraepithelial lesion (SIL), to invasive cervical cancer. In CIN I, only a few cells are abnormal, and the clinician usually recommends frequent Pap tests (every 3 to 6 months) to observe for further changes.

In moderate dysplasia (CIN II), the abnormal cells involve about half the thickness of the surface lining of the cervix. In severe dysplasia (CIN III) or carcinoma in situ (CIS), the entire thickness of cells is disordered, but the abnormal cells haven't yet spread below the surface.

Left untreated, CIS often will grow into an invasive cervical cancer. Higher grades such as CIN III or high-grade SIL are more likely to progress and should be treated aggressively. For CIN II or CIN III, a colposcopy can identify abnormal areas that can be biopsied to determine the severity and extent of the invasion.

Further treatments can include electrocautery, cryosurgery, laser surgery, loop electrosurgery excision procedure, cone biopsy, or hysterectomy. The patterns of the spread of CIN or SIL are variable. They can regress, persist, or become invasive.

Last updated Nov 26/06