Cervical Dysplasia (CIN): Questions to Ask Your Doctor

A report of cervical dysplasia is unsettling, but here is the core fact: cervical dysplasia is not cancer. It means some cells on the surface of the cervix look abnormal. Many of these changes go away on their own. The visit where you discuss the result is your chance to ask good questions. This page gives you those questions, with the background to understand the answers.

Start here, because "abnormal" covers a wide range.

A Pap test result may use terms like ASC-US, which means slightly abnormal cells where it is not clear HPV caused the change. LSIL means low-grade changes, usually caused by an HPV infection. HSIL means moderately or severely abnormal cells that could develop into cancer if untreated.

A biopsy result uses the CIN scale instead. CIN stands for cervical intraepithelial neoplasia, which is the tissue-level name for dysplasia. NCI describes three grades. CIN 1 changes are mild and usually go away on their own without treatment. CIN 2 changes are moderate. CIN 3 changes are severely abnormal and may become cancer and spread into nearby tissue if not treated.

Ask your doctor to point to the exact term on your report and say which grade it is. The plan flows from that word. Our page on what dysplasia means covers the vocabulary in more depth.

Often, yes. NCI says CIN 1 changes usually resolve without treatment. Even CIN 2 can sometimes go away on its own, which is why some people with CIN 2 are offered close watching instead of immediate treatment. In that approach, NCI describes colposcopy with biopsy every 6 months. CIN 2 must be treated if it progresses to CIN 3, or if it does not go away within 1 to 2 years.

MedlinePlus notes that mild dysplasia followed without treatment needs careful follow-up, with repeat testing every 6 to 12 months.

So the honest question for your doctor is: given my grade, my HPV result, and my history, is watching an option for me, or is treatment the safer path?

If your abnormal result came from a Pap or HPV test, the usual next step is a colposcopy. The doctor looks at the cervix through a magnifying instrument, applies a vinegar solution to highlight abnormal areas, and usually takes a small biopsy. The biopsy is what produces a CIN grade.

Timing matters as much as the test. Write down the interval your doctor gives you and ask what happens if the next result is normal, and what happens if it is not. For context, NCI notes that a negative high-risk HPV test puts the next test 5 years out, while a sample that could not be read should be repeated in 2 to 4 months. Your own schedule depends on your results.

For high-grade changes, NCI lists several ways to remove or destroy the abnormal tissue:

• LEEP uses a thin wire loop to remove abnormal tissue. It is typically done in the office with local numbing.
• Cold knife conization removes a cone-shaped piece of tissue with a scalpel, in a hospital under general anesthesia.
• Cryotherapy freezes the abnormal cells. NCI says it takes only a few minutes and usually does not require anesthesia.
• Laser therapy uses an intense beam of light and is done as an outpatient.

Ask which one fits your situation, what recovery involves, and whether the choice affects future pregnancies. Ask what follow-up testing comes after treatment, since MedlinePlus notes the condition can return and repeat exams are part of the plan.

Two answers are within your control. MedlinePlus lists smoking as a risk factor, so ask for help quitting if you smoke. And keep every follow-up appointment, because dysplasia itself usually causes no symptoms. Screening is the only way to know where things stand. People screened at regular intervals are rarely found to have cervical cancer.

Also ask whether HPV vaccination makes sense for you. MedlinePlus notes the vaccine is given between ages 9 and 45.

• Which term is on my report, and what grade is it?
• Did my HPV test find a high-risk type?
• Is it reasonable to watch and retest, or do you recommend treating now?
• If we watch, how often will I be tested, and for how long?
• If we treat, which procedure, and what does recovery look like?
• Could treatment affect a future pregnancy?
• When the changes are gone, what does my screening schedule become?

There are no wrong questions here. This is a slow-moving condition found early. That is screening doing its job. Our pages on precancerous conditions and what happens after an abnormal Pap or positive HPV test can help you prepare.

• Understanding Abnormal HPV and Pap Test Results — National Cancer Institute
• Cervical dysplasia — MedlinePlus Medical Encyclopedia