D06.1

Clinical Causes: Persistent infection with high-risk types of human papillomavirus (HPV), especially types 16 and 18. Smoking, which can impair the immune system's ability to clear HPV infections. Immunosuppression, such as in individuals with HIV/AIDS or those taking immunosuppressive medications. Multiple sexual partners and early sexual activity increase exposure to HPV. Other factors like long-term use of oral contraceptives, although evidence is still being studied.

Key Symptoms: Usually no noticeable symptoms in early stages. Possible abnormal vaginal bleeding, especially after intercourse, menstruation, or between periods. Unusual vaginal discharge that may be watery or bloody. Pain or discomfort during sexual intercourse. Persistent pelvic discomfort or pressure, although these are less common.

Diagnosis Path: - Pap smear (Pap test): detects abnormal cells on the cervix's surface. - HPV testing: identifies high-risk HPV infections involved in cervical dysplasia. - Colposcopy: a detailed examination of the cervix using a specialized magnifying device. - Biopsy: removing a small tissue sample from the suspicious area for microscopic examination to confirm CIS. - Endocervical curettage or cone biopsy may be performed if necessary for further assessment.

Treatment Protocols: - Loop electrosurgical excision procedure (LEEP): uses an electrified wire loop to eliminate abnormal tissue. - Cold knife conization: surgical removal of a cone-shaped section of abnormal tissue. - Laser therapy: destroys abnormal cells with focused laser energy. - Cryotherapy: freezes abnormal cells to destroy them. - Regular follow-up exams and Pap smears are essential after treatment to monitor for recurrence. In many cases, successful treatment of CIS prevents the development of invasive cervical cancer. It is important to follow healthcare providers’ recommendations for screening and follow-up care.