Cervical Intra-epithelial Neoplasia (CIN) refers to abnormal cell changes on the surface of the cervix (the entrance to the womb). These changes are not cancer, but if left untreated, some cases may develop into cervical cancer over many years. CIN is graded as:
- CIN1 (mild): Only 1/3 of the cervix lining has abnormal cells. Often resolves without treatment.
- CIN2 (moderate): 2/3 of the cervix lining is affected.
- CIN3 (severe): Full thickness of the lining has abnormal cells (highest risk of progression).
Causes
- HPV (human papillomavirus): Almost all CIN cases are linked to high-risk HPV types (e.g., HPV 16 or 18).
- Other risk factors:
- Smoking (weakens the immune system’s ability to clear HPV).
- Long-term use of hormonal contraceptives.
- A weakened immune system (e.g., due to HIV or immunosuppressive medications).
Symptoms
- Most women have no symptoms.
- Rarely, you may notice:
- Abnormal vaginal bleeding (e.g., after sex or between periods).
- Unusual vaginal discharge.
- CIN is usually detected during routine cervical screening (smear tests).
Diagnosis
- Cervical screening (smear test): Identifies abnormal cells or HPV.
- Colposcopy: A specialist uses a magnifying device to examine your cervix.
- Biopsy: A tiny tissue sample is taken during colposcopy to confirm the CIN grade.
Treatment Options
- CIN1:
- Often monitored with repeat tests (e.g., smear or colposcopy in 6–12 months).
- No immediate treatment needed, as it may resolve naturally.
- CIN2/3:
- Excisional treatment: Removes abnormal cells (e.g., LLETZ/LEEP or cone biopsy).
- Ablative treatment: Destroys abnormal cells (e.g., laser therapy or cold coagulation).
- Follow-up: Essential to ensure cells return to normal.
Recovery After Treatment
- Self-care tips:
- Avoid sex, tampons, and swimming for 4 weeks to reduce infection risk.
- Use sanitary pads (not tampons) for any bleeding.
- Take pain relief (e.g., paracetamol) as needed.
Possible Risks/Complications
- Short-term: Infection, bleeding, or discomfort.
- Long-term (rare):
- Cervical stenosis (narrowing of the cervix).
- Slightly increased risk of preterm birth in future pregnancies (discuss with your doctor).
Prevention
- HPV vaccination: Protects against high-risk HPV strains (offered to ages 11–13 in the UK; available up to age 45).
- Attend all smear tests: Early detection prevents cancer.
- Stop smoking: Smoking makes it harder for your body to clear HPV.
- Safe sex: Condoms reduce HPV transmission (but do not eliminate risk).
eGynaecologist Advice:
- Treatment for CIN is highly effective and mild symptoms of cramping, light bleeding, or discharge for 1–2 weeks may be normal after treatment, and most women resume normal activities within 1–2 days.
- You should attend for post treatment checks of smear tests every 6–12 months until results return to normal, as abnormal cells may return, requiring further treatment.
- You must seek gynaecological consultation if you develop heavy bleeding (soaking a pad hourly), severe pain, fever, or foul-smelling discharge (signs of infection).
