What is a CIN1 or mild dysplasia?

Mild dysplasia also called CIN1 (Cervical Intraepithelial Neoplasia grade 1) is a histological term that can only be applied after a biopsy has been performed with the aid of a colposcope.

CIN1 is a type of flat smooth wart situated in the cervix and is the result of a human papillomavirus (HPV) infection.

It is designated mild dysplasia because mild abnormalities were detected from the biopsy. These abnormalities are spread across the base of the mucous membrane similar to a fire that starts and stays on the first floors of a building and are as such the easiest to manage.

A further analogy can be used to explain dysplasia vis a vis cancer. Cancer is like a dark sky full of clouds that rain so much the rain water penetrates through to the water table. This symbolises how cancerous cells travel or spread to different locations or parts of the body, called metastases.

Mild dysplasia, following this analogy, is a clear sky with a few scattered clouds. It might possibly rain but the likelihood is small. It is more likely that a wind will come and blow the clouds away. Yet in some rare cases, the clouds group together and can obscure the sky (this is the situation where mild dysplasia progresses to moderate or severe dysplasia)

In general, and depending on the age of the patient, these abnormalities revert spontaneously (in approximately 80% of cases).

The younger the patient, the higher the rate of spontaneous reversion. If a mild dysplasia lesion type CIN1 is diagnosed towards 38 or 40 years of age, there is a strong probability that this lesion has been there for a long time. However, if this lesion is detected at age 25, it is highly probable that it is recent and at a more superficial level. The likelihood it will revert spontaneously is high because in 80% of cases the HPV infection which caused the lesion regresses during the first two years after being infected.

Inspite of the fact that these lesions should not provoke alarm, they should nevertheless be closely monitored because of their heterogeneity (under assessment) and the fact these lesions can persist or progress (less than 1% risk of cancer).

Treatment of this type of lesion is not usually given until after 18 months of monitoring and all cases require the results of the initial smear test, the colposcopy, any biopsies, and that the age profile of the patient is taken into account.

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