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Cervical intraepithelial neoplasia

What is it?

Cervical intraepithelial (in-truh-ep-e-theel-e-ul) neoplasia (nee-o-play-zhuh) is also called "CIN." Sometimes it may be called cervical dysplasia (diss-play-zhuh). CIN means that there is a change in the cells on the surface of the cervix. The cervix is the bottom part of the uterus (womb). With CIN, normal cells are replaced with cells that are not normal (abnormal). Over time, it is possible for these abnormal cells to turn into cancer.

Any woman can have CIN. CIN itself is not cancer. But it can turn into cancer of the cervix.

Following are the 3 types of CIN.

  • CIN I (1). This is also called mild dysplasia.
  • CIN II (2). This is also called moderate dysplasia.
  • CIN III (3). This is also called severe dysplasia.

Causes:

It is not known for sure what causes CIN. But it may be caused by a germ called a virus that is spread during sex. You may be more likely to get CIN if you have many sex partners or if your partner has many sex partners. A wart virus called "HPV" or human papillomavirus (pap-uh-lo-muh-vi-rus) may also cause CIN.

The following may put you at a higher risk of having CIN.

  • Less than 20 years of age at time of first sex.
  • Having a sexually transmitted disease (STD), like HPV, herpes, or cytomegalovirus (CMV).
  • A Pap smear test that is not normal.
  • Cigarette smoking.

Signs and Symptoms:

There are usually no signs and symptoms of CIN.

How do I know if I have CIN?

The best way to learn if you have CIN is a Pap smear test. A Pap smear is a screening test to check for early cancer of your cervix. Most women should have a Pap test every year. During a Pap test, your caregiver takes a sample of cells from your cervix. This sample is sent to a lab for tests.

A negative Pap test means that you probably do not have cancer. A positive Pap test means that your test results were not normal. This could mean that you have an infection on your cervix. But it could mean that you have very early or more serious signs of cancer.

You may need a colposcopy if your Pap test shows that you have CIN. Colposcopy involves using a microscope-like device to take a closer look at the cervix. Your caregiver will look at tissue on the surface of the cervix to try to see the changes that the lab found in the Pap test.

A speculum like the one used for a Pap test is put into your vagina. Next a tool called a colposcope is put close to the speculum. The colposcope is a metal tube with a tiny magnifying glass and light on the end. It shines a light on the cervix. This makes it easier for your caregiver to see the cells of your cervix.

The caregiver may take a small amount of cervical tissue (biopsy) to be sent to a lab for tests. You may have a pinching feeling or mild cramping when the samples are taken. The colposcopy and biopsy will give more information to caregivers about your CIN. A colposcopy usually takes about 15 to 20 minutes.

Wellness Recommendations:

If you smoke, quit. It harms the heart, lungs, blood, and may cause CIN. You are more likely to have a heart attack, lung disease, and cancer if you smoke. It is never too late to quit. Not only will you help yourself but also those around you. If you have trouble quitting, talk to your caregiver about ways to quit.

Medical Care:

Your caregiver can usually prevent abnormal cervical cells from spreading. But the success of this depends upon how early the abnormal cells were found and the biopsy results. The type of treatment for CIN depends upon how large an area on your cervix is involved. Sometimes no treatment is needed. Your caregiver may just want you to have more frequent Pap tests to see if the cells have changed more. But it is also possible that you may need one of the following treatments.

  • Cautery. A small metal rod puts electric current on the cervix to burn away abnormal cervical cells.
  • Cryotherapy. Using a cold gas, abnormal cells on the cervix are frozen. The freezing kills the cells so they cannot grow and spread.
  • Laser therapy. The laser releases a light beam that can dissolve tissue on the cervix.
  • Loop electrosurgical excisional procedure (LEEP). This treatment does two things. It gives caregivers more information about the abnormal cervical cells and also removes the cells. A fine-wire loop is attached to an electrical machine. The loop is used to cut out abnormal cells from the cervix. The cells may be sent to a lab for tests.
  • Cone biopsy. You may need a cone biopsy, also called a conization, if you have CIN III. This procedure is usually done in an operating room. A conization may be done to learn more about your CIN and also to treat it. A cone-sized wedge of the cervix is removed and sent to a lab for tests. The wound is repaired with stitches.

Caregivers will tell you how often you should have Pap tests. You may need to have a Pap test two times a year for the next two years. It is very important to have regular Pap tests to be sure you do not have cancer of the cervix. There is no other way to know if the CIN has come back without having a Pap test.

You may have light bloody spotting after any of the treatments. Call your caregiver if you bleed heavily. To prevent an infection or bleeding, do not have sex, douche, or use tampons for 3 to 4 weeks.

Dietary Measures:

  • Eat a healthy and balanced diet of foods rich in vitamin C, beta-carotene, and folic acid. Food that contains these are fruits, vegetables, whole grains, and legumes (beans).

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Supplements:

  • Folic acid may prevent CIN and has been studied in women with CIN.
  • Selenium has been used, but has not been studied in women with CIN.
  • Vitamin B2 (riboflavin) has been used, but has not been studied in women with CIN.
  • Vitamin B6 (pyridoxine) has been used, but has not been studied in women with CIN.
  • Zinc has been used, but has not been studied in women with CIN.

Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

Talk to your caregiver if:

  • You would like medicine to treat CIN.
  • Your symptoms have not gone away or improved by these self-help measures.
  • You have questions about what you have read in this document.

Care Agreement:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

References:

1. Butterworth CE Jr, Hatch KD, Gore H et al: Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr 1982; 35(1):73-82.

2. Kwasniewska A, Tukendorf A & Semczuk M: Content of alpha-tocopherol in blood serum of human Papillomavirus-infected women with cervical dysplasias. Nutr Cancer 1997; 28(3):248-251.


Last Updated: 11/4/2014

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