When your doctor tells you that your Pap smear report has 'abnormal cells', you must have felt a great sense of fear and shock, right? Anyone can get nervous when they hear a word like "precancerous." But let me first say, don't be nervous. This doesn't mean you have cancer. This is a condition that can be completely cured and prevented from developing into cancer if detected early. Let's talk about this simply, clearly, and without any burden on your mind.
What is cervical dysplasia?
Simply put, this is when abnormal cells grow on the surface of your cervix. Let's look at what the cervix is. It's the lower part of your uterus, the part that opens into your vagina. So, instead of the healthy cells on the surface of your cervix, a slightly different type of abnormal cell starts to grow.
Think of it like a small pothole on the road. If it's left like that, it can become a big pothole over time. But if we repair it as soon as we see it, it won't harm the road, right? That's how it is. These abnormal cells are not cancer cells. But if left untreated for a long time, there is a chance that they could turn into cervical cancer. That's why we call it "precancerous."
There is another medical name for this, which is Cervical Intraepithelial Neoplasia (CIN) . Don't be alarmed by these words. "Intraepithelial" means that these abnormal cells are only on the surface (epithelium) of the cervix, and have not spread inside. "Neoplasia" means that new cells are growing.
Are there stages of severity for this condition?
Yes, doctors classify these abnormal cells into three stages (CIN stages) depending on how deep they have spread into the cervical tissue. This is determined by examining the tissue under a microscope.
| Stage | Meaning and explanation |
|---|---|
| CIN 1 | This is the most basic and lowest risk level . Here, abnormal cells are only present in the top third of the cervix. Most of the time, our body's immune system clears it up on its own. Therefore, no major treatment is needed. |
| CIN 2 | This is a moderate condition. Abnormal cells have spread from one-third to two-thirds of the surface layer of the cervix. |
| CIN 3 | This is the most serious stage . The abnormal cells cover more than two-thirds of the surface layer. Both CIN 2 and CIN 3 require treatment to prevent cancer. |
The important thing is that CIN 1 rarely becomes cancerous. However, CIN 2 and 3 should definitely be paid attention to and treated as directed by your doctor.
What are the symptoms of this condition?
Here's what surprises many people. Cervical Dysplasia usually doesn't cause any symptoms. You may not feel any changes, pain, or discomfort.
Very rarely, some women
- Irregular vaginal bleeding.
- Slight bleeding (spotting) after sex.
Things like that can happen.
This shows how important it is to get a Pap smear on time. It's the only way to find out if you have this condition before you have any problems, without waiting for symptoms to appear.
Why is this happening? What is the reason for this?
The main and only cause of this is the virus called HPV (Human Papillomavirus) . This is a very common sexually transmitted virus.
Now you may be wondering: "If I have cervical dysplasia, do I have HPV?" Yes, that's true. But the flip side of this is not true. That is, not everyone who is infected with the HPV virus will develop cervical dysplasia. In most cases, our body's immune system can fight off the virus and completely clear it from the body within a year or two.
There are more than 100 types of HPV viruses. Some of them, especially the "high-risk" types like HPV-16 and HPV-18, are more likely to cause changes in cervical cells and lead to cervical dysplasia.
What are the factors that increase the risk?
Although it is not possible to say exactly why only some people with HPV develop cervical dysplasia, several factors have been identified that increase the risk.
- Smoking: Women who smoke or use tobacco products are twice as likely to develop this condition. Smoking weakens the body's immune system, making it less able to fight off HPV.
- Having a weak immune system: If your immune system is weakened by other illnesses (e.g. HIV) or certain medications, it may be harder for your body to clear HPV infection.
How do you find this, Doctor?
This diagnostic process happens step by step as follows.
1. Pap Smear: This is the first step. Your gynecologist will take a sample of cells from the surface of your cervix and send them to a laboratory to be examined under a microscope. This is primarily to check for abnormal cells.
2. Colposcopy: If your Pap smear shows abnormal cells, your doctor may recommend this test. This involves examining your cervix using a special light and magnifying device (like a telescope). This allows you to see any abnormal cells clearly.
3. Biopsy: If the doctor sees a suspicious area during the colposcopy, they will take a small piece of tissue and send it to the lab. This is called a biopsy. The report will confirm whether you have CIN 1, 2, or 3.
Your doctor will explain everything to you at each step. There is no reason to be afraid.
What are the treatments for this?
The treatment method is determined by many factors, including the stage of CIN you have, your age, your overall health, and whether you are planning to have children.
Treatment for CIN 1
If you have a low-risk condition (CIN 1), you probably won't need any treatment. This is because the condition is likely to clear up on its own. Your doctor will tell you, "Let's wait and see." That means getting a Pap smear at regular intervals (like every 6 months or a year) to see if the abnormal cells change or go away.
Treatment for CIN 2 and CIN 3
If you have a moderate or severe condition like CIN 2 or CIN 3, your doctor will recommend removing the abnormal cells. This has a 90% chance of curing the condition completely. There are several main methods used for this.
- LEEP (Loop Electrosurgical Excision Procedure): In this procedure, an electric wire loop is used to very finely cut and remove the area of tissue containing abnormal cells.
- Cold Knife Cone Biopsy / Conization: A cone-shaped piece of tissue is removed from the cervix using a surgical knife. This removes all abnormal cells.
- Hysterectomy: This is not done very often. Only if other treatments do not help or the condition persists, your doctor may recommend surgically removing the entire uterus and cervix, taking into account the need to have children.
Each of these treatments has its pros and cons. Your doctor will discuss with you which treatment is best for you.
How to protect yourself from this situation?
The best way to prevent cervical dysplasia is to avoid being infected with the HPV virus that causes it. There are several things you can do to help.
- Get the HPV Vaccine: This is the most important thing. This vaccine helps protect against the main types of HPV that cause cervical cancer and genital warts. If you are already infected with HPV or have cervical dysplasia, this vaccine cannot cure it. However, it can help prevent future infection with other types of HPV.
- Practice safe sex: Using condoms can reduce the risk of HPV transmission.
- Getting a Pap smear on time: While this cannot prevent the disease from developing, it offers a great opportunity to detect the disease at its earliest stages and treat it before it becomes cancerous. After the age of 21, it is recommended to get a Pap smear at least every 3 years.
- Completely abstain from smoking: As we have discussed before, smoking significantly increases the risk of this condition.
Take-Home Message
- Cervical Dysplasia is not cancer. It is just a warning sign that cancer may develop.
- The main cause of this is the very common virus called HPV.
- Often, no symptoms appear in this condition.
- The best way to detect this early is to have a Pap smear done on time.
- If detected early and treated properly, cervical cancer can be completely prevented.
- If you have any questions, fears, or doubts about this, discuss them openly with your doctor.
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