CERVICAL DYSPLASIA: HERE'S WHY YOU NEED A PAP

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WHAT IS IT

Cervical Dysplasia (CD) is a condition where abnormal or pre-cancerous cells grow in the lining of the cervix.  

 

HOW DO I KNOW IF I HAVE IT?

Typically there are no symptoms of CD (eeek!)  but spotting and painful intercourse are the most common signs. This is where pap smears come in-- your gynecologist will swab your cervix to get a cell sample for lab testing.

Getting a pap smear regularly* can help catch precancers, inflammation, infections, and viruses before cells become cancerous.

FYI: Most insurances fully cover this test.  If you don’t have insurance, pap smears run between $50-200. Call around and ask for all associated costs upfront, including lab work.

*According to the American Cancer Society, if you have a cervix and are between the ages of 21-29, you should have a Pap test every 3 years to test for cervical cancer and pre-cancers, but the HPV test is not recommended because HPV is so common during this time that it is not helpful to test for. If an abnormal pap is returned, then a HPV test is warranted. If you have a cervix and are over 30 years old, it’s recommended to get a HPV test + Pap test (co-testing) every 5 years. The American Cancer Society says that it’s also OK to continue just to have Pap tests every 3 years and test for HPV if a test comes back abnormally, but co-testing is preferred.

Those who are HIV positive or who have been diagnosed or treated for a cervical cancer or pre-cancer should talk to their health care providers about how often they should be tested for cervical cancer and what tests should be used.


WHAT CAUSES IT?

HPV is the primary cause of CD and is the most common sexually transmitted disease.

Besides HPV, the other abnormal Pap smear causes include vaginal infections as well as some common sexually transmitted diseases (STD) that can cause inflammation in the cervix and lead to abnormal Pap test results referred to as atypical squamous cells of undetermined significance (or ASCUS).

 

WHAT IF I HAVE AN ABNORMAL PAP RESULT?

While every practitioner and every body is different, if you have a Pap result of ASCUS, here is a general idea of what may happen next:

The option to repeat the Pap in 6 months and if the result is still positive, proceed to colposcopy, where a larger sample of tissue is taken for investigation.

Alternatively, the cervical cells can be tested for high risk HPV strains. A Pap result of ASCU plus a negative HPV test is followed up with a repeat Pap in 6 to 12 months. If the HPV test is positive, colposcopy is still warranted.

FYI: An HPV test costs between $50 and $200, depending on the lab. Many insurance companies cover the cost if it’s screening women over 30. Some companies will cover the cost of HPV testing for women under 30 with an inconclusive or abnormal Pap test result (Vachani).

 

IF I’M DIAGNOSED, WHAT DO I DO? IS IT CONTAGIOUS?

According to Johns Hopkins’ Sidney Kimmel Cancer Center, treatment depends on the degree of the lesion, which is based on colposcopy results. Mild cervical dysplasia CAN clear up naturally, with a healthy immune system. For moderate to severe lesions there’s a few surgical options that range from in-office to outpatient: burning the cells electrically, freezing off with cryotherapy, or cutting it out. It is important to continue regular appointments with your provider to ensure full removal.

Cervical dysplasia is not contagious, but HPV is.
 

IF I HAVE HPV, WHAT CAN I LOOK OUT FOR/DO PREVENTATIVELY SO IT DOESN’T BECOME CERVICAL DYSPLASIA?


WITHOUT HPV, WHAT CAN I DO PREVENTATIVELY?

  • Regular visits to your gyno for a pelvic exam AND pap smear test
  • If you are feeling concerned or know you have been exposed to HPV, ask to be tested, even if it has been less than 3 years.
  • HPV vaccines are available starting at age 9 to lower the risk of HPV in the first place. The vaccine protects against the two types of high-risk of HPV that account for 70% of cervical infections. (There are a total of 40 strains so it doesn’t protect against all HPV). All vaccines mean introducing the virus into the body, so always do your research and ask your practitioner all of your questions to see if it is the right choice for you!
  • Use protection while engaging in sexual activities to reduce your chance of getting HPV.
  • Treat your body like it’s the most important thang (cause it is!)
  • Avoid smoking cigarettes

 

THE SILVER LINING

We know this can be scary.  But knowledge is power! Now that you’ve read the above, you can take steps to protect yourself and you can be on the offensive with a care provider if you do have HPV.

Cell changes in the cervix happen very slowly… it usually takes more than 10 years for cell changes to become cancer. So regular check-ups are key!


CHECK THIS OUT:

Dr. Cornelia Liu Trimble, director of the Cervical Dysplasia Center, is working on a technology that prevents pre-cancerous lesions from turning into cancer by teaching the immune system to differentiate between precancerous and cancerous cells via killer T-cells. Check out her Tedx Talk!

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ADDITIONAL SOURCES:

https://www.hopkinsmedicine.org/kimmel_cancer_center/centers/cervical_dysplasia/

 

Written By: Gretchen Decker, CA

**Disclaimer** This post is intended as informational only, and should not be treated as medical advice.