What does cervical high-grade squamous intraepithelial lesion (CIN2 to CIN3) mean, and what should be done about it?

In general, high-grade squamous intraepithelial lesion of the cervix (CIN2 to CIN3) may be caused by long-term smoking, early onset of sexual activity, prolonged use of oral contraceptives, high-grade squamous intraepithelial cell changes, and persistent infection with high-risk types of HPV. Timely medical treatment is recommended. Specific analyses are as follows:

1. Long-term smoking

If healthy individuals smoke for a prolonged period, various carcinogens in tobacco can enter the body, stimulating cervical epithelial cells and interfering with immune system function, thereby increasing the risk of developing high-grade squamous intraepithelial lesions (CIN2 to CIN3). It is recommended that patients reduce smoking frequency or quit smoking altogether, engage in regular physical exercise, and maintain a light diet.

2. Early onset of sexual activity

Cervical high-grade intraepithelial neoplasia includes CIN2 and CIN3, with CIN3 considered a precancerous condition of cervical cancer. If sexual activity begins at a very young age when reproductive organs have not fully matured, it may lead to high-grade squamous intraepithelial lesions (CIN2 to CIN3).

3. Prolonged use of oral contraceptives

If healthy individuals take oral contraceptives such as compound levonorgestrel tablets, mifepristone tablets, or other hormonal contraceptives for extended periods without medical supervision, hormonal imbalances may occur, stimulating cervical tissue and potentially leading to high-grade squamous intraepithelial lesions (CIN2 to CIN3). Patients are advised to adopt alternative contraceptive methods and avoid long-term use of hormonal contraceptives.

4. High-grade squamous intraepithelial cell changes

One component of cervical cancer screening is liquid-based cytology. If this test reveals high-grade squamous intraepithelial cell changes (HSIL), there is a significant possibility of underlying high-grade cervical lesions (CIN2 to CIN3). A colposcopy-guided cervical biopsy is required for further evaluation. Patients with cervical intraepithelial neoplasia grade 2 to 3 are at increased risk of developing cervical cancer. Therefore, cervical biopsy is recommended within one week after menstruation ends. For patients diagnosed with CIN2 to CIN3, cervical cold knife conization may be necessary to accurately determine the nature of the lesion.

5. Persistent infection with high-risk HPV

High-grade squamous intraepithelial lesions (CIN2 to CIN3) are primarily caused by persistent infection with high-risk types of human papillomavirus (HPV). If left untreated, these lesions may progress to cervical cancer; therefore, active management is essential to prevent serious outcomes. Even after surgical treatment for high-grade cervical lesions under medical guidance, recurrence is possible, so regular follow-up examinations are necessary. Regular cervical TCT (thin-prep cytology test) and HPV testing should be performed. Colposcopy and cervical biopsy should be conducted when indicated. Prompt intervention upon detection of abnormalities can help prevent the development of cervical cancer.

Patients are advised to maintain healthy sexual habits and undergo regular gynecological examinations.