Cervical dysplasia and human papillomavirus

Evidence suggests a link between human papillomavirus infections and cervical dysplasia-carcinoma. This has led to the recommendation that when human papillomavirus infections are identified on the cervix, especially in association with dysplasia, these patients should have colposcopic assessment and treatment. The natural history of cervical human papillomavirus infections, particularly when associated with mild or moderate dysplasia, is not clear. To assess this question, 235 women with mild to moderate cervical dysplasia associated with a human papillomavirus infection were prospectively evaluated at 6-month intervals by the Colposcopy Clinic. This review suggests that mild to moderate cervical dysplasia associated with human papillomavirus infection eventually spontaneously disappears or, at worse, lingers on over many months in a mild to moderate form. These observations do not support the current popular practice of treating all mild to moderate cervical dysplasias associated with human papillomavirus infection or cervical human papillomavirus infection not associated with dysplastic lesions.