Usually, there are no symptoms of cervical dysplasia. Genital warts are a sign that someone has been exposed to certain types of HPV, which are different from the types that are most likely to lead to cervical dysplasia and cancer. It is important to note that people can have HPV and not have genital warts or any other symptoms. Similarly, there are often no physical symptoms of cervical cancer, especially in the early stages.
In advanced stages of cervical cancer, there may be pain in the abdomen or lower back, pain or bleeding while having vaginal intercourse, unusual vaginal discharge, or bleeding between menstrual periods. To do a Pap test, the doctor inserts a tiny brush and a small wooden spatula into the vagina and rubs them over the cervix to loosen and collect cells.
The cells are smeared on a glass slide that is sent to the lab for study. The Pap test helps identify abnormal cells. For people with HIV, Pap tests are usually done twice during the first year after HIV diagnosis, followed by once a year if the first two tests showed normal results.
However, many physicians with HIV-positive people in their care recommend doing a Pap test every six months. Although Pap tests are useful, they can produce "false-negative" results.
In other words, the lab may report a test result as "normal" when there actually are changes in the cells of the cervix. This is the reason why HPV testing is being used more and more in addition to Pap tests.
For HPV testing, doctors can collect a small amount of fluid from the cervix and have it tested for the presence of HPV. Many doctors recommend that people with a cervix who have been newly diagnosed with HIV have a colposcopy. A colposcope is a microscope that looks into the vagina, which has been opened by a speculum, and allows the doctor to visually examine the cervix. The cervix is lightly washed with a weak vinegar solution before the colposcope is put in place.
The vinegar solution makes abnormal cells stand out more clearly against the surrounding tissue. When a colposcopy is performed, a biopsy removal of a tiny piece of tissue from the cervix and sometimes an endocervical curettage the scraping of tissue from the cervix will be done by the doctor. This procedure can be somewhat painful or cause cramps. The biopsy sample allows lab technicians to study the tissue and confirm the status of cervical tissue. Pap tests are done by family physicians and gynecologists as part of regular medical care.
However, colposcopies and biopsies are done mostly, but not exclusively, by gynecologists. An HIV-positive person with signs of abnormalities on the cervix, vagina, or vulva should also have an anoscopy, or visual inspection of the anus and anal canal using a microscope similar to a colposcope. This is because the cell changes caused by HPV can also occur in the anus and lead to anal dysplasia.
If someone is diagnosed with HPV, partner notification is not required as a public health measure, unlike with a chlamydia, gonorrhea, syphilis or HIV diagnosis. Treatment for cervical dysplasia and cancer varies from one person to another, depending on the location and size of the lesion or cancer, and whether the lesion is low grade or high grade or whether the cancer has spread to other parts of the body. Whether or not the person wishes to become pregnant also affects treatment decisions.
People with cervical cancer may be referred to a gynecologist-oncologist or an oncologist—a doctor who specializes in the treatment of cancer. Although cervical dysplasia and cancer can be treated successfully, HIV-positive individuals are at high risk for having this cancer reappear. It is important to follow up treatment with regular Pap tests and a colposcopy every three to six months.
ART cannot prevent cervical cancer. However, with regular gynecological exams and Pap tests, studies have found that cervical cancer is not common in these individuals in high-income countries. Practising safer sex by using condoms or having non-penetrative sex can help reduce the risk of becoming infected with HPV. However, condoms do not completely eliminate the risk of HPV transmission because the virus may be present on skin not covered by the condom.
Condoms also reduce the risk of other STIs that contribute to the development of dysplasia and cancer. Stopping cigarette smoking can help reduce the risk of cervical dysplasia and cancer. Three vaccines against HPV genotypes are available in Canada. Gardasil 9 protects against HPV types 6, 11, 16 and 18 as well as types 31, 33, 45, 52 and 58 which can also cause cancer.
Indicators of protective effects have lasted for at least 10 years after vaccination in some trials. For either vaccine to work, three doses given over six months are necessary. The vaccines do not provide protection against HPV that people are already infected with, but provide excellent protection against HPV the person has not been exposed to. Also the vaccines have not been shown to be effective for the treatment of established HPV infection and are not approved in Canada for this use.
Gardasil and Cervarix should be avoided in people who are pregnant. Gardasil can be given to people who are breastfeeding, while Cervarix should only be used during breastfeeding when the possible advantages outweigh the possible risks. It is important to remember that even if someone has received one of the vaccines, they are only protected against the cancer-causing HPV types covered by the vaccine they have received. Regular medical check-ups with pelvic examinations and cervical cancer screening with Pap tests for women and transmen in their 20s and viral testing starting in their 30s are still needed to help all people, regardless of their HIV status, reduce their risk of cervical cancer and watch for signs of cervical dysplasia and cancer.
Cervical dysplasia is not cancer but must be treated to prevent the possibility of it developing into cancer. Cervical cancer is a serious condition, especially for HIV-positive people. The earlier it is found, the better the chances are for successful treatment.
Tests may include: another Pap test after a few months usually 6 months if there are mild changes an HPV test, which can sometimes be done on a sample of cervical cells taken during a Pap test a colposcopy exam and biopsy of any abnormal-looking areas an endocervical curettage, which removes cells from the endocervical canal and is usually done at the same time as a colposcopy.
Find out more about a Pap test , a colposcopy and a biopsy. It is hard to predict which of these will become invasive cervical cancer, so they are usually treated as soon as they are diagnosed. Treatment options for precancerous changes in the cervix may include: loop electrosurgical excision procedure LEEP or other cone biopsy procedure cryosurgery laser surgery hysterectomy. Precancerous conditions of the cervix. Types of precancerous conditions.
Abnormal squamous cells. SILs are divided into low grade and high grade. CIN is graded as 1, 2 or 3. Abnormal glandular cells. Risk factors. Tests may include: another Pap test after a few months usually 6 months if there are mild changes an HPV test, which can sometimes be done on a sample of cervical cells taken during a Pap test a colposcopy exam and biopsy of any abnormal-looking areas an endocervical curettage, which removes cells from the endocervical canal and is usually done at the same time as a colposcopy Find out more about a Pap test , a colposcopy and a biopsy.
Mild changes to the cervix often return to normal on their own without any treatment. Cancer of the cervix, vagina and vulva. Cancer: Principles and Practice of Oncology. Cervix uteri. Principles and Practice of Gynecologic Oncology. Philadelphia: - Request Appointment. Cervical dysplasia: Is it cancer? Products and services. I had a Pap test recently, and my doctor said the results showed cervical dysplasia. What does that mean? Is it cancer? Answer From Shannon K. Laughlin-Tommaso, M.
Multimedia Colposcopy. With Shannon K. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. Something went wrong on our side, please try again. Show references Ferri FF. Cervical dysplasia. In: Ferri's Clinical Advisor Philadelphia, Pa. Accessed Jan. Hoffman BL, et al. Preinvasive lesions of the lower genital tract.
In: Williams Gynecology. New York, N.
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