What Is Low-Grade Squamous Intraepithelial Lesion?
Low-grade squamous intraepithelial lesion (LSIL), also called mild dysplasia, is an area of abnormal cells forming on the cervix's surface. The condition can also affect the vagina and vulva, anus, penis, or back of the throat. This condition may develop in both women and men. It is commonly detected through a routine Pap test that helps detect cervical cancers, precancers, and other cervical cell abnormalities. The cells have only a few abnormal characteristics in these low-grade lesions but are somewhat similar to the normal cells. So instead, these lesions are precancers; they have the potential to become cancer and spread to other tissues.
What Causes Low-Grade Squamous Intraepithelial Lesion?
LSIL typically develops after the specialized squamous cells on the surface of the cervix get infected by the human papillomavirus (HPV). Infected cells in the lesion show an abnormal pattern of development. Although this condition is considered a non-cancerous disease, there may be a small risk of turning into cancer called squamous cell carcinoma over time. However, for most people with LSIL, the immune system may remove the infected cells, and the tissue will return to normal. Although LSIL is not contagious, human papillomavirus is a sexually transmitted infection that can spread through vaginal, anal, or oral sex.
What Are the Symptoms of Low-Grade Squamous Intraepithelial Lesions?
LSIL usually does not have any symptoms. Instead, most people find out they have it after undergoing a Pap test. For that reason, regular screenings are essential for the early diagnosis and treatment of LSIL cases. Some people may experience the following symptoms in their genitals, including:
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Abnormal discharge or bleeding.
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Burning or itching sensation.
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Pain.
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Redness.
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Genital warts.
Who is at Risk for Low-Grade Squamous Intraepithelial Lesions?
People are at an increased risk of developing LSIL if:
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They have a suppressed immune system and human papiloma virus (HPV) infection, making it harder for the body to eliminate abnormal cells caused by the virus.
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They are smokers and have HPV, as the chemicals in tobacco increase the risk of cell damage and affect the immune system.
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They have multiple sexual partners (vaginal, anal, or oral sex) and unprotected sex, which may increase the risk of HPV infection.
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Older women with HPV infections during their teenage years or early adulthood are also at greater risk of developing LSIL.
What Happens After Low-Grade Squamous Intraepithelial Lesion Is Discovered on Pap Test?
After the diagnosis of LSIL in pap test, the healthcare professional base the treatment recommendations on certain factors like age, the number of abnormal Pap tests, and other cervical cancer risk factors, including:
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A repeat Pap test and HPV test should be done immediately or in 12 months.
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In addition, an HPV type test may be performed to look for HPV types 16 or 18, the types generally associated with cervical cancer.
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Colposcopy may also be performed. Colposcopy is a medical diagnostic procedure where the doctor closely examines the cervix with a magnifying device. The doctor may take a sample and send it to a laboratory for biopsy if any abnormality is found during a colposcopy.
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A second Pap test has abnormal findings that must be repeated in 12 months. For normal results, a regular screening schedule is followed.
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Because LSIL can progress and develop to HSIL and potentially cancer, following through with testing as recommended is essential.
How Are Low-Grade Squamous Intraepithelial Lesions Treated?
If human papillomavirus does not go away on its own and Pap tests continue to show abnormal results (LSIL), it is necessary to remove abnormal cells. The health care professionals may recommend the following treatments, including:
Excisional Surgery:
Excisional surgery is a method of removing abnormal cells. In this procedure, cervical tissue is removed and sent to a laboratory for further analysis. Excisional surgery is done in two ways:
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Loop Electrosurgical Excision Procedure (LEEP): In this treatment, the doctor uses a thin wire with an electric current to remove the abnormal areas.
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Conization: The procedure involves the removal of a cone-shaped piece of the cervix where the abnormal cells were found using a scalpel.
Ablative Treatment:
Ablative treatment is another treatment the doctor may recommend. The ablative treatment destroys the abnormal tissue and is performed in two ways:
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Cryosurgery: In cryosurgery, the doctor uses extreme cold produced by liquid nitrogen to freeze off the abnormal tissue.
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Laser Therapy: The doctor uses a powerful, focused light beam to destroy abnormal cervical tissues.
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Topical Treatments: People with LSIL may apply creams or ointments that contain hormones or substances to stimulate their immune system.
What Is the Prognosis or Outlook for People With Low-Grade Squamous Intraepithelial Lesion?
LSIL often clears up on its own or can be effectively treated with available treatments to help prevent the development of cervical cancer. However, some people may experience discomfort for a few days and can expect some discharge for a few days to a few weeks, depending on the procedure. Although LSIL is not cancer, regular follow-up is needed. Pap screenings are essential for identifying and treating abnormal cells before they become cancerous.
How Are Low-Grade Squamous Intraepithelial Lesions Prevented?
The best way to prevent low-grade squamous intraepithelial lesions is by getting the HPV vaccine. Girls and boys aged 9 to 14 can get the HPV vaccine series, two or three shots spaced two to 12 months apart. People who get the vaccine when they are older need three doses between ages 15 and 45. If older than 46, consult a healthcare professional before getting the HPV vaccine. Other ways to reduce the risk of HPV include:
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Limit the sex partners to minimize possible exposure to HPV.
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Stick to the proper screening guidelines for the age and risk level. Talk to a health care professional about the proper screening guidelines for the age and risk. For example, people may need more frequent screenings if they tested positive for HPV or had abnormal Pap smears in the past.
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Use condoms.
Conclusion
Low-grade squamous intraepithelial lesions are precancerous conditions caused by HPV infections characterized by mild abnormalities in cervical cells. Usually, most LSILs resolve on their own without treatment, but others need immediate treatment to remove the abnormal tissue. Although LSIL is not cancer, regular follow-up is necessary. Pap screenings are essential for identifying and treating abnormal cells before they become cancerous.
