DYSKARYOSIS (DISS – CARRY – OSIS)
Dyskaryosis is when there is an abnormality of the nucleus (central part) of a cell. When identified in a cervical screening sample, dyskaryosis is classified into three groups:
- Mild dyskaryosis – mild or slight cell changes identified
- Moderate dyskaryosis – more moderate cell changes identified
- Severe dyskaryosis – a severe level of cell changes identified
If your cervical screening sample shows any dyskaryosis, your clinician may wish to perform further tests, where samples (biopsies) of the abnormal areas of the cervix may be taken. The biopsies are examined under a microscope to determine the thickness of the surface layer of the cervix that has been affected. The biopsy results will be reported as a grade of Cervical Intra-epithelial Neoplasia (CIN).
This is a change in the squamous cells in the surface layer of the cervix which, if left untreated, occasionally go on to become squamous cell cervical cancer. CIN is divided into grades, which describe how far the abnormal cells have gone into the surface layer of the cervix.
- CIN 1 – one-third of the thickness of the surface layer of the cervix is affected.
- CIN 2 – two-thirds of the thickness of the surface layer of the cervix is affected.
- CIN 3 – the full thickness of the surface layer of the cervix is affected.
With all three grades of CIN, often only a small part of the cervix is affected by abnormal changes. Sometimes a screening test may find changes in the glandular cells that line the cervical canal. However, it is much less common for changes to occur in these cells. Changes to these cells go through the same stages as CIN and are called CGIN, which stands for cervical glandular intra-epithelial neoplasia. If not monitored, or left untreated, CIN and CGIN have the potential to develop into a cancer of the cervix.
HPV is an abbreviation for Human Papilloma Virus. This is a group of viruses which can interfere with the cell functions that normally prevent excessive growth. These will commonly cause warts on hands and some strains can affect the genital area. Most adults will have had an HPV infection at some time in their lives, and in most cases this will be short lived and your body will deal with it. When the infection persists in women, there is the likelihood of cervical abnormalities. Only a small number of women with an HPV infection will have an abnormal cervical screening test result and an even smaller number of these women will go on to get cervical cancer.
Key facts about HPV
- There are over 100 types of HPV
- Approx 1 in 20 women will have HPV at any particular time
- Virtually all women who are, or have been sexually active will be infected with a genital HPV at some time in their lives
- Some types of HPV (‘low risk’) can cause genital warts
- Some types of HPV (‘high risk’) can cause pre-cancerous cell changes and in a small number of women, cancer of the cervix
- Cervical cancer is a very rare complication of HPV infection
- Most HPV infections will go away on their own
- The majority of women infected with HPV clear the virus without treatment
Not all women will develop CIN or cervical cancer. However, almost all women with CIN and cervical cancer have had HPV infection.
Genital HPV is acquired in almost all cases through close intimate or sexual contact, but the infection is so common and so subtle that referral to a GUM (Genito-urinary medicine) clinic is not appropriate. No antibiotics or other treatment for HPV infection is required.
Women who smoke may find that their ability to clear HPV infection from the body is reduced, and clearance of minor cervical screening abnormalities could be slower and less efficient. Stopping smoking may be advised by your GP, practice nurse and Mr Chattopadhyay.
Any abnormality detected on cervical a screening test will require further examination in the colposcopy clinic by Mr Chattopadhyay and treatment may be required.