Cervical Intraepithelial Neoplasia (CIN)
What is cervical intraepithelial neoplasia?
Cervical intraepithelial neoplasia (CIN) is an abnormal growth of cells on the cervix. The cervix is the lower part of the uterus that opens into the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus.
CIN is not cancer, but it can become cancer of the cervix if it is not treated.
How does it occur?
You have a greater risk for CIN if:
- You have an HPV infection (human papillomavirus). This is the most common cause of CIN.
- You have had more than 1 sex partner.
- Your sex partner has been sexually active with other partners.
- You had sexual intercourse before the age of 18.
- You smoke.
- You were exposed to DES when your mother was pregnant. DES, or diethylstilbestrol, is a medicine that in years past was given to some women to prevent miscarriage.
- You have a weakened immune system; for example, because you are taking immunosuppressive drugs or because you have AIDS.
- You have had a sexually transmitted disease.
What are the symptoms?
Usually CIN does not cause symptoms. Sometimes it causes bleeding during or after sex or a change in your vaginal discharge.
How is it diagnosed?
A Pap test can find cell changes in the cervix. If it does, then some cervical tissue may be removed for further tests with a procedure called a colposcopy.
To do a Pap test, your healthcare provider puts a speculum into your vagina. The speculum is a tool that holds open the walls of the vagina so your provider can see the cervix. Your provider then gently collects cells from your cervix and cervical canal. Cells from the cervix are sent to a lab for tests.
A colposcopy gives your healthcare provider a closer look at your cervix. For this procedure an instrument with a magnifying lens (a colposcope) is used to look at the cervix. Your provider may put a special vinegar-like liquid on the cervix to see the cells better. Your provider may use an instrument to pinch or cut off a small tissue sample for lab tests. The removal of the sample tissue is called a biopsy.
How is it treated?
Your provider may recommend treatment of CIN to try to help stop it from becoming cervical cancer. The type of treatment may depend on whether the CIN is mild, moderate, or severe.
Mild cervical intraepithelial neoplasia, also called CIN 1, usually goes away without treatment. If you have CIN 1, your healthcare provider will probably want to do another Pap test in 6 to 12 months and possibly a colposcopy. If a follow-up Pap test shows CIN again, your healthcare provider may recommend another colposcopy and biopsy.
If you have moderate cervical intraepithelial neoplasia, called CIN 2, your provider may remove the abnormal tissue right away or follow you closely with another Pap test and colposcopy in 6 to 12 months. The abnormal tissue may be removed with a thin wire loop attached to an electrical unit. This is called the loop electrosurgical excisional procedure (LEEP). A laser or surgical knife is another way to remove the abnormal tissue. You do not have to stay in the hospital for any of these procedures. They can be done in your provider's office.
For severe cervical intraepithelial neoplasia, called CIN 3, your provider will do a cone biopsy, which is the removal of a cone-shaped piece of the cervix. This procedure is also called conization of the cervix. It removes the tissue containing abnormal cells. Your provider can cut the tissue out with a surgical knife, laser, or LEEP. If a cone biopsy is done with a knife or laser, it is usually done in an operating room. LEEP may be done in your provider's office. The tissue removed is examined in the lab to check for cancer.
Very few women have trouble getting pregnant or have miscarriages as a result of any of these treatments. Most women are able to carry the baby to term without problems. However, you should tell your prenatal care provider about any cervical treatments you have had.
How can I take care of myself?
After a Pap test that shows CIN, follow your healthcare provider's advice for treatment and checkups. Your provider may recommend that you have a Pap test at least twice a year for the next 2 to 3 years. This will let your provider find CIN if it comes back and treat it promptly. If your Pap tests are normal for 2 to 3 years, you may then need the test just once a year.
How can I help prevent cervical intraepithelial neoplasia?
To lower your risk of CIN:
- Try to avoid exposure to HPV. Do not have more than 1 sexual partner. It will also help if your partner has not been sexually active with anyone else. Find out if your partner has had any sexually transmitted diseases. You can get some protection from HPV by using latex or polyurethane condoms every time you have sexual intercourse. However, condoms do not completely protect against this infection, which can be spread from other parts of the body.
- Avoid sexual intercourse until you are 18 or older.
- Do not smoke. Avoid breathing smoke from other people's cigarettes.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.
HIA File wome5213.htm Release 13/2010