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Home  > Cervical Dysplasia > Stages of cervical dysplasia

Stages of cervical dysplasia

Women are understandably concerned when an abnormal Pap smear is reported, which occurs rather frequently. Depending on the lab terminology used, the lesions are subdivided into dysplasias (mild, moderate, severe); cervical intraepithelial neoplasias (CIN I, II, and III); or low-grade and high-grade squamous intraepithelial lesions (LGSILs and HGSILs).

The HGSILs (i.e., moderate and severe dysplasias, CIN II and III lesions) are recognized as precancer lesions. The LGSILs (i.e., very mild dysplasia and mild dysplasias, condylomata and CIN I lesions), have shown that one of the most important denominators of their cancer potential is the presence of high-risk HPV types.

HPV typing provides the most rational basis for selecting women with LGSILs to be colposcoped and treated or given follow-up treatment with Pap smears.

Other Paps may report ASCUS (atypical squamous cells of undetermined significance), AGCUS/AGUS (atypical glandular cells of undetermined significance), or koilocytotic atypia (HPV effect).

Women with abnormal Paps are often scheduled for an expensive and uncomfortable procedure such as a colposcopy (and biopsy) to better stage the cervical dysplasia. Deeper involvement into the epithelial lining of the cervix earns the more severe labels such as CIN II-III or severe dysplasia. VIN is a variant that involves the vulva (vulvar intraepithelial neoplasia).

Normally it takes several years or more for severe dysplasia to progress to cervical cancer. Usually progression to cervical cancer does not occur. However, progression is determined by many factors including, most importantly, HPV type and the status of the cellular immune system of the individual.

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Dr. Joe Glickman, Jr., M.D.

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