What a Cervical Intraepithelial Neoplasia Diagnosis Means

Cervical intraepithelial neoplasia (CIN), or cervical neoplasia, is a particular type of change in the cervix that may or may not be a precursor to cervical cancer. In fact, a cervical neoplasia diagnosis can apply to a wide range of changes to the cervix. These changes can range from self-resolving mild to moderate cervical dysplasia to the early stages of cervical cancer.

Doctor holding cervical smear equipment
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Defining Cervical Intraepithelial Neoplasia

The cervical in cervical intraepithelial neoplasia has an obvious meaning. It refers to the uterine cervix. To understand what cervical intraepithelial neoplasia is, it helps to understand the other terms as well.

Intraepithelial means "within the epithelium." The muscular structure of the cervix is covered with layers of several types of epithelial cells. It is these cells that are affected by cervical intraepithelial neoplasia.

Neoplasia refers to abnormal or uncontrolled cell growth. Thus, cervical intraepithelial neoplasia is abnormal cell growth within the layers of epithelial cells that cover the cervix.

When diagnosed by Pap smear, cervical dysplasias are generally known as squamous intracellular lesions (SIL) instead of cervical interepithelial neoplasias. The cervical neoplasia diagnosis is reserved for diagnosis by biopsy or colposcopy. This is because Pap smears provide the examiner with loose cells.

In contrast, biopsies allow them to see any cervical damage in context. This gives doctors the ability to perform a more accurate diagnosis.

Grading

Cervical neoplasias are diagnosed by biopsy and graded according to their severity as follows:

Grade  Definition
CIN I Mild dysplasia
CIN II Mild to moderate dysplasia
CIN III Severe dysplasia to cancer

CIN I

People who are diagnosed with CIN I are generally not treated, as this type of cervical damage often heals without intervention. Instead, they are followed up closely by their doctor. That may include more frequent Pap smears, HPV testing, or possibly colposcopy.

CIN I correlates with a low-grade squamous intraepithelial lesion (LSIL) diagnosis from a Pap smear.

CIN II and CIN III

CIN II and CIN III correspond to high-grade squamous intraepithelial lesion (HSIL), high-grade squamous intraepithelial lesion (ASC-H), atypical glandular cells (AGC), or carcinoma in situ Pap smear diagnoses. In contrast to CIN I patients, those with either of these two grades are almost always referred for treatment.

Treatment for moderate to severe cervical neoplasias involves the removal of the lesions, which can be done through:

Even after treatment to remove the lesion, individuals with high-grade cervical neoplasias remain at increased risk of developing cervical cancer in the future. They are generally advised to continue visiting their doctors for more frequent follow-up.

Does Cervical Neoplasia Mean Cancer?

Being diagnosed with cervical neoplasia does not mean you have cancer. It doesn't even mean that you are going to get cancer. What it does mean is that you are probably at an increased risk of developing cancer at some point in the future. That is particularly true if you are diagnosed with CIN II or CIN III.

Your absolute cancer risk is still low after a CIN II or III diagnosis. However, your doctor will probably recommend regular follow-up. That will help make sure they can catch cancer early if it does develop. Early diagnosis and treatment is a critical step in limiting mortality from cervical cancer.

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