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  • Q&A with Australian Health Practitioners

    Adenocarcinoma insitu, is this cancer?

    I've recently had a colposcopy and one on the three biopsies came back as possible adenocarcinoma insitu. The other 2 were high grade CIN3 with likely active hpv 16. Im 38 and have 2 children, 4 months and 3 yrs. All previous paps were negative for last 10 yrs. Is this normal for it to have progressed this fast? and what treatment can I expect for this?
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    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Adenocarcinoma in Situ is a premalignant disease and according to studies takes 5 years for it to progress to adenocarcinoma of the cervix. CIN3 and AIS are different histologic types of cancer.  The two are different cancers affecting different cells on the cervix: one affects glandular cells and the other affects squamous cells. You also have to keep in mind that a pap smear is a screening tool and the pickup rate is around 60-70%. But we know that abnormal cervical changes progress to cancers slowly hence obtaining a smear every 2 years is sufficient.

    The treatment after a positive biospy showing AIS is the following:

    You will undertake a cone biopsy. A cone biopsy removes a larged conical specimen of the cervix to have more tissue for examination under the microscope. At the same time, the specialist will perform an endocervical curette (scraping the inside of the cervix).

    Adenocarcinoma in situ and adenocarcinoma of the cervix are referred to as skip lesions. This means that even if the margin is clear with the cone biopsy, there is a possibility there are more lesions that will be missed higher up. The recommendation would be for a hysterectomy if you have completed your family. Alternatively, you can have the cone biopsy followed by close surveillance.

    Good luck.

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