What is dysplasia

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What is dysplasia?

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Dysplasia is an abnormal growth of the skin cells

of the cervix, vagina or vulva. The nucleus of the

cell enlarges and the whole cell becomes more

active. Dysplasia is not cancer but it is felt

that dysplasia cells are on a growth pattern in

which they can turn into a cancer over time. When

the cells get to a point where they are so active

they are reproducing faster than they are dying

off, the extra cells grow into normal tissue and

become an invasive cancer.

No one knows for sure what causes these cells to

become so actively growing but it is strongly

suspected that certain strains of human papilloma

virus (HPV) cause or promote these changes. The

Pap smear picks up these nuclear activity changes

but in early phases it can not always distinguish

between inflammatory or irritation changes. These

Paps are classified as atypical squamous cells of

undetermined significance (ASCUS) or mild

dysplasia.

Much work is going on with HPV typing of abnormal

Pap smears (The Digene Hybrid Capture® HPV test)

to try to tell if the particular strain of HPV

that is associated with the abnormal Pap is one of

the " high risk " strains of HPV known to be

associated with cancer. In theory if the HPV is a

high risk type, doctors might need to be more

aggressive in treating the tissue involved rather

than waiting for the Pap smear to get worse before

treating. Conversely, if the virus associated with

an abnormal Pap is a low risk (for cancer) type,

then screening with repeat smears can be put off

longer. In practice, it becomes very expensive to

do both tests and the long term outcome is not

much different.

Some studies have even suggested that HPV typing

smears may be cost effective in replacing Pap

smears for the detection of moderate and severe

dysplasia to prevent cancers of the cervix. We are

not at that point yet but this test bears

watching.

http://gyncancers.about.com/health/gyncancers/library/weekly/aa050101a.htm

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Dysplasia 101</A>