High Grade Squamous Intraepithelial Lesion (HSIL)

(Content revised 04/2023)

If a cervical screening test shows High Grade Squamous Intraepithelial Lesion, it means that there is moderate or severe degree of deteriorating cell changes. If left untreated, 1 to 2 in every 100 women may develop cervical cancer. In order to make an accurate diagnosis, these women need colposcopic examination during which tissue biopsy will be taken for further test, as such treatment can be advised accordingly. Successful treatment with regular follow-up cervical smear test can minimise the risk of cervical cancer.

The development of cervical cancer is a long process. The cells of the cervix gradually undergo a series of changes from normal cells to abnormal cells, to mild, moderate, then severe deterioration, and finally to cervical cancer. Apart from continual worsening of cell changes, at any time, the cell changes can also spontaneously regress to normal. However, even if the cell changes already show severe deterioration, it can still take up to 5 to 10 years before cancer finally appears.

Treatment

The doctor will insert a speculum into the vagina, stain the vagina and cervix with special medicinal solution and then use a colposcope to identify any abnormal lesion. If an abnormal lesion is found, the doctor will use an equipment to extract a small piece of the tissue and send it to the laboratory for examination.

If there is no invasive cancer, treatment will be confined to the cervix. Treatment options include excision or destruction of the lesion. Loop electrosurgical excision procedure and laser therapy are the commonly used methods. The operation takes about 30 minutes and can be done in the general treatment room under local anaesthesia.