Cervical dysplasia after treatment in children

Overview

Cervical dysplasia is a condition where abnormal cells grow on the lining of the cervix (the lower part of the uterus). It is not cancer, but if left untreated it can sometimes turn into cancer over many years. After treatment, the goal is to remove the abnormal cells and prevent them from coming back. In children, this condition is extremely rare, but if a child has been treated, careful follow-up is important to make sure the cells stay normal.

No, cervical dysplasia is not common in children. It is extremely rare. When it does occur, it is usually in young women, not in children under age 18.

Cervical dysplasia primarily affects sexually active women. In children, it is exceptionally rare and may be linked to certain medical conditions or treatments that weaken the immune system (such as organ transplant or HIV). Routine screening for cervical dysplasia does not start until age 25 in many countries, so the condition is almost never looked for in children.

Symptoms

Common symptoms

• Cervical dysplasia usually does not cause any symptoms.

Symptoms in children

• As in adults, cervical dysplasia in children is typically symptom-free. Symptoms rarely occur unless the changes become more advanced.

Symptoms in older adults

• Cervical dysplasia is most often found during routine screening and has no symptoms. If it progresses, it might cause abnormal bleeding (after sex or between periods) or unusual discharge.

Causes

Main causes

• Infection with high-risk types of human papillomavirus (HPV) — a very common virus passed through skin-to-skin contact, usually during sexual activity.

Risk factors

• Having a weakened immune system (for example, from an organ transplant, HIV, or long-term steroid use)
• Early onset of sexual activity (not applicable to children in most cases)
• Multiple sexual partners (not relevant for children)
• Smoking (unlikely in children)
• Long-term use of birth control pills (not relevant)

When to see a doctor

See a doctor urgently if:

• If your child has any unusual vaginal bleeding or discharge

Book a routine appointment if:

• If you have concerns about your child’s health, talk to your pediatrician or family doctor.
• If your child has been treated for cervical dysplasia, follow the recommended schedule for check-ups and Pap tests.

Diagnosis

Cervical dysplasia is found through screening tests, which are not routinely done in children. In the rare case it is suspected (for example, if a child has an abnormal Pap test or symptoms), a specialist will examine the cervix with a colposcope (a magnifying lens) and may take a small sample of tissue (biopsy) to check the cells.

Tests that may be done

• Pap test (also called a Pap smear) — a swab collects cells from the cervix. This is not done in children unless there is a specific medical reason.
• HPV test — looks for high-risk types of HPV. Often done with a Pap test.
• Colposcopy — a doctor uses a special microscope to look at the cervix closely.
• Biopsy — a small piece of tissue is removed from the cervix to be examined under a microscope.

What to expect at your appointment

If your child needs a colposcopy or biopsy, the doctor will explain the procedure. It may be uncomfortable but should not be painful. After a biopsy, there may be some spotting or mild cramping. Your child will need to avoid heavy activity for a day or two. Results take about a week.

Treatment

Treatment for cervical dysplasia removes the abnormal cells. After treatment, regular follow-up is needed to make sure the cells do not come back. In children, treatment is the same as in adults but is rarely needed.

Self-care at home

• Follow your doctor’s advice about when to come back for check-ups.
• Encourage a healthy lifestyle with a balanced diet and regular exercise to support the immune system.
• If your child is old enough, talk about the HPV vaccine to prevent future infections.

Medical treatments

Medical treatments for cervical dysplasia include procedures that remove or destroy the abnormal cells. Common options are loop electrosurgical excision procedure (LEEP), cryotherapy (freezing the cells), laser therapy, or cone biopsy (removing a small cone-shaped piece of tissue). These are done in a doctor’s office or clinic under local or general anesthesia. The choice depends on the extent of the dysplasia and the child’s age.

When is surgery considered?

Surgery, such as a cone biopsy, might be recommended if the abnormal cells are more severe or if the initial treatment did not completely remove them. Full hysterectomy (removal of the uterus) is almost never needed for cervical dysplasia, especially in children.

Living with this condition

After treatment, most children can return to normal activities quickly. The main thing is to keep up with follow-up appointments to monitor the cervix. Your child may need Pap tests more often for a few years.

Lifestyle tips

• Encourage your child to eat a diet rich in fruits and vegetables to support a healthy immune system.
• Make sure your child gets the HPV vaccine (if not already vaccinated) to reduce the risk of future HPV-related problems.
• Avoid smoking exposure and secondhand smoke.

Diet and exercise

A balanced diet with plenty of vitamins and minerals can help the immune system fight HPV. Regular physical activity is good for overall health. There is no special diet for cervical dysplasia, but a healthy lifestyle is always beneficial.

Mental health and emotional wellbeing

Being diagnosed with a condition that involves the reproductive organs can be stressful for a child and their family. It may raise questions about future fertility and sexual health. It is important to offer reassurance that most cases of cervical dysplasia are treatable and that the risk to long-term health is small. If your child feels anxious or upset, talk to a counselor or therapist who works with children.

Prevention

The best way to prevent cervical dysplasia is to get the HPV vaccine, which protects against the types of HPV that cause most cases. Avoiding smoking and practicing safe sex (when older) also help. For children, vaccination is the key preventive step.

Vaccines

The HPV vaccine is recommended for both boys and girls starting at age 11 or 12. It is given as a series of two or three shots. The vaccine is very effective at preventing infection with the most dangerous HPV types. If your child has not yet received it, ask your doctor about it.

Screening programmes

Routine cervical screening (Pap tests) is not recommended for children. It usually begins at age 25 in many countries (like the UK) or at age 21 in the US, regardless of sexual activity. For children who have been treated for cervical dysplasia, follow-up screening is done according to a specialist’s advice.

Complications

If left untreated

• If cervical dysplasia is not treated, it may progress to cervical cancer over many years (usually 10-20 years). This is very rare in children.
• Untreated dysplasia can sometimes come back after initial treatment if follow-up is not done.
• In very rare cases, extensive treatment might affect fertility, but this is unlikely in children with limited treatment.

Long-term outlook

The outlook for a child who has been treated for cervical dysplasia is excellent. Most children do not have any long-term problems, and the risk of the dysplasia returning is low if they follow the recommended follow-up. With the HPV vaccine and regular screening later in life, they can stay healthy. It is important to stay hopeful and keep up with medical care.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.