Cervical Dysplasia
What is it?
Cervical dysplasia is an abnormal growth of tissue in the cervix (the neck or opening of the uterus). Most cases are harmless but sometimes the abnormal cells may become cancerous. In such cases, the average time for progression to cervical cancer is from one to seven years.
Causes of cervical dysplasia
There are several lifestyle and nutritional factors that increase the risk of cervical dysplasia. These include viral infections such as herpes simplex and human papillomavirus (HPV), smoking, lowered immunity and oral contraceptive use. Lower socio-economic status, multiple sexual partners and early age of first intercourse also increase the risks.
Regular gynecological examination decreases cervical cancer mortality as cervical dysplasia can be caught in the early stages before it progresses to cancer. This examination, known as a Pap test, can accurately detect up to 90 per cent of cervical cancers, even before symptoms develop. Since its introduction, the number of deaths from cervical cancer has been reduced by more than 50 per cent. It is usually recommended that women have their first Pap test when they become sexually active or reach the age of 18. Tests can be performed annually but women who have had a normal test for three consecutive years, may wait for two to three years.
Cervical Dysplasia and diet
As cervical dysplasia is a pre-cancerous condition, an anticancer diet may help to lower the risk of disease occurrence and progression. Diets high in saturated and polyunsaturated fats are likely to promote cancerous changes while a diet high in fruit, vegetables and fiber may help to reduce the risks.
Vitamins, minerals and cervical dysplasia
Several vitamin deficiencies may play a role in cervical dysplasia. A 1993 study of the links between diet and cervical dysplasia found a relationship between low folate, vitamin E, vitamin C and riboflavin intakes and the disease.1
Folate
The risk of cervical dysplasia appears to increase as folate intake decreases. It is possible that localized changes in folate levels contribute to cervical dysplasia. Some women appear to have normal levels of blood folate while concentrations in the cervical tissues are low. This may be due to use of oral contraceptives, which alter folate metabolism. Some researchers have found a higher risk of abnormalities in cervical tissue in women using oral contraceptives and suggest that folic acid supplements are beneficial in preventing cervical dysplasia in these women.2
Low red blood cell folate levels may increase the effect of other risk factors for cervical dysplasia; in particular, that of HPV infection. In a 1992 study, researchers from the University of Alabama in Birmingham investigated the links between folate deficiency and cervical dysplasia in 294 young women with the disorder and 170 healthy women. They also assessed the impact of factors such as smoking, oral contraceptive use, HPV infection, and number of sexual partners. The results showed that at low folate levels, the risk of dysplasia caused by HPV infection was increased.3
Even a marginal folic acid deficiency causes breaks and damage to the genetic material of the cell that resembles cervical dysplasia and, as this deficiency is common, some abnormal Pap smears may reflect folic acid deficiency rather than true dysplasia. However, it is also possible that such alteration in genetic material is an integral component of the dysplastic process that may be stopped, or in some cases reversed by oral folic acid supplementation. Several clinical studies have shown improvements in Pap smears in those with cervical dysplasia when they are given folic acid supplements. Folic acid supplementation may protect abnormal cells from becoming cancerous and may reverse cervical dysplasia in some cases. A 1996 study suggests that supplements may be useful in preventing the initial changes but do not appear to affect the progress of established disease.4
Antioxidants
Several studies have found links between low antioxidant levels and cervical dysplasia,5 including carotenes6 and vitamin E.7
Vitamin A
Epidemiological studies have links between low dietary intake or blood levels of vitamin A and the development of cervical dysplasia and/or cervical cancer. A 1996 Japanese study involving 137 women found a higher risk in women with low vitamin A levels.8
Some clinical investigations have examined the use of local application of a form of vitamin A to the cervix. In a 1994 placebo-controlled study, researchers examined the effects of this in 301 women with cervical dysplasia. The results showed that the treatment reversed mild dysplasia, but was not effective in more advanced cases.9
Vitamin C
Vitamin C levels have been shown to be lower in women suffering from cervical dysplasia. A 1981 US study measured nutrient intake in 87 women with cervical dysplasia and 82 women with no symptoms. Average vitamin C intake for those with cervical dysplasia was 80 mg and for healthy women, 107 mg. Women with intakes of less than 50 per cent of the RDA may have ten times the risk of cervical dysplasia than those with high intakes.10
Zinc
Some studies have shown that zinc levels may be low in cervical dysplasia.11 Zinc is vital for many immune functions and can be protective against precancerous changes.12