Which are the symptoms?
Cervical dysplasia is completely asymptomatic. HPV infection is also asymptomatic. The evolution of dysplasia into cancer can be manifested by spotting, intermenstrual bleeding and foul-smelling vaginal discharge that is not justified by other causes.
How is it diagnosed?
In cases where a screening examination (Pap test and/or HPV test) reveals a cytological abnormality, colposcopy is the next diagnostic step. Colposcopy is an outpatient examination that is easy to perform and risk-free for the patient, aiming at a precise observation of the vagina and cervix. During colposcopy, one or more biopsies can be taken at the site of the lesion in order to obtain an anatomo-pathological opinion of the dysplasia, which will be useful for the subsequent clinical management of the patient.
How is it treated?
The most common treatments for cervical dysplasia are laser, cervical diathermocoagulation and conization (LEEP).
Treatment is divided into destructive or ablative (laser vaporisation and diathermocoagulation of the cervix, in which pathological tissue is destroyed) and excisional (conization, in which pathological tissue is removed and examined by a pathologist). Factors influencing the choice of treatment include the degree and severity of dysplasia, the age of the woman, her desire to get pregnant in the future and the possible presence of other gynaecological problems.
The goal of cervical dysplasia treatment is to remove the lesion and stop progression to cervical cancer. However, regardless of treatment, there is a possibility of dysplasia recurring. Depending on the type of lesion diagnosed, periodic check-ups after treatment are necessary (colposcopy with cytology and HPV molecular-biological test).
The prevention of cervical dysplastic lesions has been made possible by the introduction of the HPV vaccine. Studies on the use of this vaccination, originally recommended only for girls and adolescents, have shown its usefulness for all women under 45 years of age, regardless of their clinical history of papillomavirus positivity and/or history of cervical dysplastic lesions. In adults, vaccination includes 3 doses at 0, 2 and 6 months of age (should be avoided during pregnancy).