Stopping cervical cancer in its tracks

You got the results of a recent screening back and your doctor says they show “precancerous cervical changes.” But what exactly does that mean?

Well, the short answer is: It means exactly what it sounds like. Your screening found cells in your cervix that are suspicious but not yet cancerous.

But that doesn’t really explain things, does it? Let’s take a deeper dive into these changes — and how they can be treated.

Understanding the causes of cervical cancer

Most precancerous cervical changes and cases of cervical cancer are caused by the human papillomavirus, often referred to as HPV.

HPV is very common — in fact, as many as 80 percent of women will develop an HPV infection by the time they turn 50. In most cases, the HPV infection will resolve on its own as the body’s immune system fights it off.

But in some cases, HPV can lead to cervical lesions, or precancerous cervical changes, that can develop into cervical cancer if left untreated.

HPV, precancerous cervical changes and cervical cancer are all often silent, meaning they don’t cause noticeable symptoms. That’s why it’s vitally important to have regular screenings.

Screening for cervical cancer

While there’s no treatment for HPV infections, you can stop precancerous cervical changes from developing into cervical cancer with early detection and removal.

The key to early detection? Following guidelines for cervical cancer screenings.

The United States Preventive Services Task Force recommends that women undergo a Pap smear every three years between ages 21 and 65 — or for women ages 30 to 65, undergo co-testing with a Pap smear and HPV testing every five years.

Of course, those are just general screening recommendations. Your doctor can recommend an ideal screening schedule for you based on your personal health history, family health history and lifestyle habits.

When a woman undergoes a Pap smear, a sampling of cervical cells is removed and screened for abnormal cells. If the Pap smear shows anything abnormal, you and your doctor can determine next steps.

When screening shows precancerous cervical changes…

These precancerous cell changes are also called cervical dysplasia. There are multiple types of dysplasia — categorized by the severity of the cellular changes.

Depending on the specific level of dysplasia, your doctor will recommend additional testing or treatment.

• Atypical Squamous Cells of Undetermined Significance — This is the most common abnormal Pap test result, and it means that the cells don’t look completely normal but the cause can’t be determined. Most often, doctors recommend that those with this test result undergo an HPV test to see if HPV is present and undergo a follow-up Pap smear within 12 months.
• Atypical Glandular Cells — This result means that some cells looked abnormal. With this result, doctor typically recommend additional testing with a colposcopy and biopsy.
• Low-Grade Squamous Intraepithelial Lesions — This test result is often called mild dysplasia or CIN1, and it means that there are low-grade cervical changes present. Additional testing, including a colposcopy and biopsy, is recommended to determine the severity of the changes.
• Atypical Squamous Cells, Cannot Exclude HSIL — This result means that there are abnormal squamous cells present, and additional testing, including colposcopy and biopsy, is recommended.
• High-Grade Squamous Intraepithelial Lesions — This test result is often referenced as moderate or severe dysplasia, or CIN2, CIN2/3 or CIN3. With this result, serious cervical changes are present and may develop into cervical cancer if not treated. Colposcopy and biopsy are recommended.
• Adenocarcinoma In Situ — This test result means that an advanced lesion was found in cervical tissue and may advance into cancer if not treated. Colposcopy and biopsy are recommended.

During a colposcopy, a doctor will examine your cervix using a colposcope, a special magnifying instrument. In most cases, the doctor will also remove cervical tissue to biopsy it for cervical cancer.

Treatment for precancerous cervical changes

Depending on the severity of changes present, a doctor may elect to re-test within a certain period of time to determine if the changes have gone away on their own. They often do.

But in some cases, these cervical cell changes don’t disappear. The positive side of cervical cancer is that it typically takes years for precancerous cervical changes to develop into cancer.

That means that regular screening, combined with prompt treatment if necessary, can usually mitigate the risk of cancer.

If a doctor determines that it’s necessary to remove these cervical changes, there are multiple options for doing so. These include cone biopsy, where a cone-shaped piece of cervical tissue is removed; cryotherapy, where a cold probe is used to destroy abnormal tissue; and LEEP (loop electrosurgical excision procedure), where an electrical current is passed through a thin wire loop to remove abnormal tissue.

All of these procedures can be performed in a physician’s office, typically using only local anesthesia.

Your best defense against cervical cancer? Regular screenings. Talk with your doctor about the screening schedule that’s best for you.

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