Cervical cancer screening: what does it mean when CIN is detected?

Written by: Mr Angus McIndoe
Edited by: Bronwen Griffiths

Cervical cancer most commonly affects younger women, so it is important to have regular cervical smear tests to ensure that any sign of pre-cancerous cells is dealt with. If abnormalities are detected in a smear test, you may be referred for a colposcopy. This is a test that uses a microscope to closely inspect the cervix. CIN is one such abnormality that a colposcopy can detect. Mr Angus McIndoe, a leading gynaecologist, explains what CIN is and how they can be treated.

What is CIN?

CIN stands for cervical intraepithelial neoplasia. It sounds like big long medical words, but it is easy enough to understand if you take it apart. Cervical means it is on the cervix, intra means it is within, epithelial is skin, and neoplasia is cells growing faster than they should be. Therefore, cervical intraepithelial neoplasia just means that there are some cells in the skin of the cervix which are growing a bit faster than they should be.

How is CIN treated?

CIN is graded as low grade or high grade, or CIN 1, 2 and 3. With a low-grade abnormality, which is CIN one, we tend to watch and wait (i.e. we do not treat them at all). With a high-grade abnormality, CIN 2 and 3, what we do is remove them by cutting out the little bit of skin that is abnormal. This can be done in a variety of ways:

  • With loop diathermy, commonly called LLETZ or LEEP.
  • With a needlepoint, which allows you to very precisely cut out just the bit of skin that is abnormal.
  • We can also use laser to remove the abnormality, or many years ago, people used to use a scalpel to cut it out, but very few people do that nowadays.
  • The alternative treatment is an ablation where people use heat treatment to kill the cells that have the CIN.

Hence, we are able to tailor the treatment much more to the individual woman and individual abnormality that they have got. One problem with the ablation method is that you may not know what exactly has been treated, and occasionally, this kind of treatment misses an early cervical cancer. Therefore, most of us feel that excisional techniques are the better option.

By Mr Angus McIndoe
Obstetrics & gynaecology

Mr Angus McIndoe is one of the UK's leading consultant gynaecologists based in London. After qualifying in New Zealand in 1980, he moved to England where he began working at the Whittington Hospital, gaining invaluable experience in surgical training. In 1986 he started training in colposcopy, and is now one of the field's most respected practitioners. He is a leading specialist in gynaecological oncology, treating cancers in the female reproductive organs, including endometrial, ovarian, vulval, cervical, and fallopian tube cancers.

Working in some of London's most prestigious hospitals and clinics, including the Wellington Hospital and the Hammersmith Hospital, has gained him a formidable reputation amongst his peers. He is particularly noted for his meticulously honed skill when performing complex pelvic surgery. His use of cutting-edge robotic surgical techniques in the treatment of benign and malignant tumours puts him at the forefront of obstetrics and gynaecology.

Always looking for new and innovative ways to improve treatments and surgical techniques, his research has included molecular immunology of HPV, and imaging in gynaecological oncology. Lately he has been investigating the healing of caesarian section scars. As well as giving lectures and training surgeons across Europe, he has also published extensively. He aims to give his patients the best service possible, keeping them informed and supporting them through each step of the way.

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