Am Fam Physician. 2009;80(2):online
See related article on cervical screening tests.
What is cervical dysplasia?
The cervix (SIR-vicks) is the lower opening of the womb. A sexually transmitted infection called human papillomavirus (pap-il-LO-muh-VIE-russ), or HPV, can infect the cervix. HPV can cause changes in the cells of the cervix. These changes are called dysplasia (diss-PLAY-zhuh), or precancer (abnormal cells that may become cancer). With the help of your immune system, HPV sometimes goes away without treatment. Otherwise, it may need to be treated. Sometimes HPV can cause cancer. A Pap test can tell your doctor how bad the dysplasia is and whether or not your cervix should be treated.
Who is at risk?
Anyone who has had sex can get HPV infection. Your risk of dysplasia is higher if you have more sex partners, smoke cigarettes, have an illness or infection that lowers your ability to fight it off (such as kidney transplant or human immunodeficiency virus [HIV] infection), or started having sex before age 18.
What happens if I have it?
Your doctor may decide if you need a second Pap test in six months, an HPV test, or a colposcopy (cole-POSS-cuh-pee). Follow your doctor's advice so that any problems are found early.
The HPV test checks for some types of the virus that cause cervical dysplasia or cancer. If your test is negative, you're not at risk for cancer.
Colposcopy is another way to check your cervix. During this procedure, a microscope magnifies the surface of your cervix so your doctor can see the changes caused by HPV. He or she may take a sample of your cervix to see how bad the dysplasia is and if you need treatment.
There is a chance your cervix could heal on its own without treatment. Teenagers' bodies are more likely to fight off HPV and heal the cervix, so they may not need treatment. If the test results show that a more serious problem is present, the abnormal cells may need to be treated by freezing the cervix or removing part of it.
How can I lower my risk of cancer?
Your immune system has a better chance of fighting off HPV if you stay healthy and do not smoke. You can lower your chances of getting new HPV infections by limiting your number of sex partners and by always using condoms with new partners. It is important that you listen to your doctor and return for further testing if needed.