Cervical dysplasia is abnormal growth of the cells that line the surface of the cervix. The cervix is the lower part of the uterus (womb) and is situated at the upper end of the vagina (ACOG 2014). Dysplastic cells can vary in their degree of abnormality from mild to severe, and dysplasia has several possible outcomes: it may disappear entirely, remain stable over time, or progress to cancer (Ho 2011; ACOG 2013a; Moore 2007). However, only a small percentage of women diagnosed with dysplasia will go on to develop cervical cancer, which is one of the most preventable cancers (ACOG 2013a; ACOG 2011a).
Cervical cancer used to be a common cause of death from cancer among American women. However, from 1955 to 1992, the cervical cancer death rate decreased by almost 70%, primarily due to increasing use of the Papanicolaou (Pap) test. This screening test can detect changes in the cervix before cancer develops or while cancer is still in its early stages, when treatment is generally most effective (ACS 2014a). Early diagnosis and treatment can prevent progression of dysplasia to cancer in as many as 90% of women (ACOG 2011b).
Most cases of cervical dysplasia and cervical cancer are associated with human papillomavirus (HPV) infection, which infects nearly all sexually active men and women at some point in their lives (CDC 2014). Fortunately, HPV types highly likely to cause cervical cancer can be vaccinated against (Fiks 2014; NCI 2012). However, at present, many women and girls are not vaccinated, possibly as a result of misperceptions about the vaccines or a lack of awareness because these vaccines are relatively new (Fiks 2014; Delere 2013; Etter 2012). This is unfortunate because HPV vaccination is highly effective in reducing risk of infection with high-risk HPV types (Ferris 2014; Luna 2013).
Low intake of several vitamins may increase risk of cervical cancer. Studies have shown that women with lower intakes of vitamins A, C, and E are at increased risk of cervical cancer (Kim 2010; Peng 1998). Also, women with low concentrations of B vitamins, especially folate, may have an increased risk of cervical dysplasia or cervical cancer (Butterworth 1982; Piyathilake 2004; Liu 1993; Butterworth 1992; Butterworth, Hatch 1992; Kwasniewska 2002; VanEenwyk 1992; Kwanbunjan 2006).
In this protocol you will learn about factors that increase risk of cervical dysplasia and how cervical dysplasia is classified. The benefits and risks of currently available treatments will also be reviewed, and evidence on integrative interventions such as B vitamins and diindolylmethane (DIM), which have been studied in the context of cervical dysplasia, will be presented. Novel and emerging therapies including new types of HPV vaccines will be discussed as well.