Dysplasia (pre-cancerous change)
Abnormal-looking cells in a surface lining that are not yet cancer but are on the way. Finding and removing dysplasia (cervical smears, Barrett's surveillance, colon polyps) is how screening prevents cancer rather than just detecting it early.
Dysplasia is graded low or high by how disordered the cells and architecture are; high-grade dysplasia is treated because a substantial fraction progresses to invasive cancer. Cervical intraepithelial neoplasia (CIN 2-3) is excised or ablated; Barrett's with dysplasia is ablated by radiofrequency after endoscopic resection; adenomatous polyps are removed at colonoscopy; oral leukoplakia and anal intraepithelial neoplasia are watched or treated. Atypical hyperplasia of the breast raises risk and can justify preventive tamoxifen. Carcinoma in situ is the most severe form, in which the whole epithelium is malignant but has not invaded.
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