What are the differences between CIN 1, 2 and 3?

 After a colposcopy, your doctor will take a/multiple biopsies to determine the nature of abnormal cells in your cervix.

Normal result 

If you get a normal result, this means no abnormal cells are present and you do not need immediate treatment. Continue with your regular pap smears and HPV tests, of course.

Abnormal result

If you have an abnormal result, it means there are abnormal cells prevent in your cervix, otherwise known as cervical intra-epithelial neoplasia (CIN). CIN is graded between 1 to 3, with 1 being the mildest and 3 being the most severe.

Receiving a CIN result does NOT mean you have cancer, however it assesses the risk of the abnormal cells turning into cancer if untreated.

CIN 1

It is unlikely the cells become cancerous and may go away on its own. Your doctor may recommend another colposcopy in 6-12 months to monitor the cells. Note that the practice in Singapore is to monitor the cells every 6 months, however in the US and UK the practice is to monitor every 12 months. Please discuss with your doctor what is right for you. 

CIN 2

There is a moderate chance the cells could become cancerous and treatment is recommended.

CIN 3

There is a high chance the cells could become cancerous and treatment is recommended. 

Beyond CIN 3: Cervical Cancer

In rare cases, a colposcopy and biopsy will find cervical cancer. Discuss with your doctor immediate next steps. 

This blog post does not cover treatment of CIN. Please read literature available online and also consult with your doctor which treatment plan makes the most sense for your unique set of circumstances. I often recommend getting at least two opinions before committing to one treatment plan as different hospitals and clinics have different types of treatment depending on the latest innovations available to them. 

In Singapore, these are the guidelines for most doctor offices regarding CIN treatment: https://www.sccps.org/wp-content/uploads/2019/03/CSS-Clinical-Mgt-Guidelines-2019_March-Release.pdf 

This blog post also does not cover the intricacies of cervical cancer. That may be a blog post for the future! 

Resources:

https://www.nhs.uk/conditions/colposcopy/results/

https://www.nhs.uk/conditions/colposcopy/treatment/

https://www.sccps.org/wp-content/uploads/2019/03/CSS-Clinical-Mgt-Guidelines-2019_March-Release.pdf