Dear OncoLink "Ask The Experts,"
Two years ago, I had a LEEP procedure for cervical intraepithelial neoplasia II (CIN II). All of my Pap smears have been normal since, until a recent Pap showed CIN I, which was biopsy-confirmed. I am thinking about becoming pregnant. Should I wait? I've heard that hormone changes can cause rapid progression of the cancer cells?
Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:
The LEEP (Loop Electrosurgical Excision Procedure) is quite effective in eliminating cervical dysplasia, with cure rates of about 85%. In some patients, dysplasia may return after LEEP. If so, the dysplasia is usually picked up on Pap smear, which may prompt further evaluation with colposcopy and biopsy, as was done in your case. With only mild dysplasia (CIN 1) found on biopsy, your gynecologist may have elected to follow you to avoid further treatment to your cervix, since in many cases the dysplasia will regress on its own over time. I would suggest discussing your interest in becoming pregnant with your gynecologist, as it would be best to get your Pap smear problem cleared up prior to pregnancy.