See Van diagnosed with low-grade cervical dysplasia.

Posted: February 3rd, 2024

See Van, a 35-year-old married Hmong-American woman, recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal. 

Her provider diagnosed her with low-grade cervical dysplasia. 

What alterations at the cellular level would you expect to see with this diagnosis? Provide and discuss S. V.’s prognosis with your colleagues.

Support your discussion with citations from the textbook, external credible literature and/or reliable electronic sources.

Understanding low-grade cervical dysplasia

Low-grade cervical dysplasia is an important topic because it’s a relatively common finding on Pap tests, and it can be confusing and anxiety-provoking for patients. Understanding what it means and how it’s managed is key to providing good care.

What is Low-Grade Cervical Dysplasia?

• Definition: It’s the presence of mildly abnormal cells on the surface of the cervix. It’s considered a precancerous condition, but it’s important to emphasize that it’s not cancer.
• Cause: The majority of cases are caused by infection with certain types of human papillomavirus (HPV), a common sexually transmitted infection.
• Terminology:

• It’s also referred to as cervical intraepithelial neoplasia 1 (CIN 1) or low-grade squamous intraepithelial lesion (LSIL).
• These terms are often used interchangeably, but they essentially mean the same thing.

Why is it Important to Discuss?

• Prevalence: It’s quite common, especially in younger women. Many women will have it at some point in their lives.
• Natural History: Most cases of low-grade dysplasia resolve on their own without any treatment. The body’s immune system often clears the HPV infection, and the abnormal cells revert to normal.
• Progression to Cancer: While the risk is low, a small percentage of cases can progress to higher-grade dysplasia or even cervical cancer if left untreated.
• Anxiety and Uncertainty: Receiving a diagnosis of low-grade dysplasia can be stressful for patients. It’s important to provide clear explanations and reassurance.

Management of Low-Grade Cervical Dysplasia:

• Observation: The most common approach is observation with repeat Pap tests or HPV testing at regular intervals. This allows healthcare providers to monitor for any changes or progression.
• Colposcopy: In some cases, a colposcopy may be recommended to get a closer look at the cervix and take a biopsy if needed.
• Treatment: Treatment is usually not necessary for low-grade dysplasia, but it may be considered if the dysplasia persists or progresses. Treatment options include cryotherapy, laser therapy, or loop electrosurgical excision procedure (LEEP).

Key Points to Discuss with Colleagues:

• Importance of Shared Decision-Making: Involve the patient in the decision-making process, explaining the risks and benefits of different management options.
• Individualized Approach: Consider the patient’s age, medical history, and preferences when making recommendations.
• Patient Education and Counseling: Provide clear and accurate information about low-grade dysplasia, its natural history, and management options. Address any concerns or anxieties the patient may have.
• Follow-Up: Ensure that patients understand the importance of follow-up care and adhere to recommended screening schedules.
• HPV Vaccination: Discuss the importance of HPV vaccination for preventing cervical dysplasia and cervical cancer.

By having open and informed discussions with colleagues, we can ensure that patients with low-grade cervical dysplasia receive appropriate and evidence-based care.