Vaginal dysplasia after cervical dysplasia
Dear OncoLink "Ask The Experts,"
At age 30 I had a total hysterectomy due to cervical dysplasia. All annual pap smears in the years following have been normal. I also have an annual ca 125 blood draw - all normal. I am now 42, and received a phone call from my gyn today to inform me that I had atypical cells show up in my pap smear. I am scheduled for a colposcopy. If I don't have a cervix, how can I have dysplasia again? Should I be concerned?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
Unfortunately, women who have had cervical dysplasia in the past are at risk for vaginal dysplasia even after hysterectomy. The top of the vagina is adjacent to the cervix and cells there may be under the same influences as the cervix even after removal. While no one knows for certain the causes of vaginal cancer, it seems logical to assume that factors that predispose to cervical abnormalities may be equally as damaging to the vaginal tissue. You and your gynecologist are doing the right thing by pursuing colposcopy to check for any dysplastic lesions. I cannot tell you what caused your abnormal Pap test, but if you are a smoker, I would recommend that you stop because of the possible increased risk.