Precancerous changes in the cervix are abnormal cells in the lower part of the uterus that opens into the vagina. The uterus is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus, through the cervix.
The medical term for this problem is cervical intraepithelial neoplasia, or CIN. CIN is not cancer, but it can become cancer of the cervix if it is not treated.
What is the cause?
The most common cause of CIN is infection with human papillomavirus (HPV). There are many types of HPV and they can infect different parts of the body. Some types infect the genital area and can develop into CIN or cancer.
You have a greater risk for CIN if:
You started having sex when you were a teen.
You have more than 1 sex partner or you have a partner who has had many other partners. (This increases your risk of HPV infection.)
You have a sexually transmitted disease or infection (STD or STI).
You have a weakened immune system–for example, because you are taking immunosuppressive drugs or because you have AIDS.
You were exposed to DES when your mother was pregnant. DES is a medicine that in years past was given to some women to prevent miscarriage.
What are the symptoms?
Usually CIN does not cause symptoms. Sometimes it causes:
Bleeding during or after sex
A change in vaginal discharge
How is it diagnosed?
Your healthcare provider will ask about your symptoms and sexual and medical history and you will have a pelvic exam. Tests may include:
HPV test, which can be done at the same time you have a Pap test
Colposcopy, which uses a type of microscope placed just outside the vagina to get a close-up view of your cervix. Your healthcare provider may use a tool during this exam to take a biopsy. A biopsy is the removal of a small sample of tissue for testing.
How is it treated?
Mild CIN usually goes away without treatment. Your healthcare provider may recommend treating some types of CIN to stop it from becoming cancer. Treatment may include:
LEEP (loop electrosurgical excisional procedure) to remove the abnormal tissue with a thin wire loop attached to an electrical unit
Cone biopsy to remove a cone-shaped piece of tissue from your cervix. A scalpel, a laser, or an electrical current may be used to do the biopsy.
Very few women have trouble getting pregnant or have miscarriages as a result of these treatments. Most women are able to carry a baby to term without problems. However, if you get pregnant, you should tell your prenatal care provider about any cervical treatments you have had.
How can I take care of myself?
Get a pelvic exam, Pap test, and HPV test as often as recommended by your healthcare provider. This will let your provider find CIN if it comes back and treat it promptly.
Follow your healthcare providerâ€™s instructions. Ask your provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent CIN?
To lower your risk of CIN:
Practice safe sex:
Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex. However, condoms do not completely protect against HPV, which can be spread from other parts of the body.
Have just 1 sexual partner who is not having sex with anyone else.
If you have had sex and are worried that you may have been infected, see your healthcare provider even if you donâ€™t have any symptoms.
If you have been sexually assaulted, you may need to be treated to prevent sexually transmitted infections. You should have an exam within a few hours of the assault (and before showering or bathing) even if you donâ€™t want to press charges. You can also ask about being protected from pregnancy when you have the exam.
Ask your healthcare provider about getting the vaccine that helps prevent types of HPV infection that increase your risk for cervical cancer. The vaccine is approved for females and males between the ages of 9 and 26 years.
Avoid having sex until you are 18 or older.
If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-02-07 Last reviewed: 2014-02-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Precancerous Changes in the Cervix: References
ACOG Practice Bulletin: Screening for Cervical cancer, Number 131, November 2012.
ACOG Practice Bulletin: Management of Abnormal Cervical Cancer Screening Test Results and Cervical Cancer Precursors, Number 140, December 2013.
American Society for Colposcopy and Cervical Pathology. Management and Screening Guidelines. 2014. Web. http://www.asccp.org/Guidelines, Accessed February 3, 2014.
Holschneider, C., et al. Cervical intraepithelial neoplasia: Definition, incidence, and pathogenesis. http://www.UpToDate.com Accessed on February 3, 2014.
Schorge, J., J. Schaeffer, L. Hoalvorson, B. Hoffmen, K. Bradshaw, F. Cunningham. Williams Gynecology. 1st ed. The Mcgraw Hill Companies, Inc. 2008. Accessed February 1, 2009 from http://www.accessmedicine.com.