Dyskaryosis

Dyskaryosis of the uterine cervix is a condition in which some of the epithelial cells near the os show abnormalities in their cellular nuclei.

These changes are often quite subtle, and are often seen as temporary changes in girls between the ages of fifteen and twenty-five. Apparent dyskaryosis in girls below the age of twenty-five is not regarded as significant, and accordingly in most countries where a cervical screening programme exists, the age of entry into the programme is twenty-five. The programme terminates at the age of sixty-five, assuming no abnormal smears in the previous ten years.

Cervical dyskaryosis is classified into four degrees of severity - borderline, mild, moderate and severe. While any dyskaryotic cervix might develop malignant change, so all must be followed up, the risk is increasingly high with higher grades of dyskayosis. Most borderline changes will resolve spontaneously, as will many mild ones. Moderate and severe changes are usually treated, by electrocautery, cryocautery or loop excision, with the object of completely removing the abnormal area.

Dyskaryosis is caused by an infection with Human Papilloma Virus (HPV) which exists in a number of different strains; type 16 and type 18 cause dyskaryosis more readily than do other types. [Clinical Evidence Concise, BMJ Publications] These viruses are nearly always sexually transmitted. Immunization, which is now available against HPV 16 and 18, will prevent further infection by these strains. But if infection has occurred before immunization, and cellular change has already occurred, the vaccine does not reduce the risk of developing dyskaryotic change.

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