Cervical Dysplasia & HPV Care

An abnormal Pap smear, positive HPV test, CIN2 or CIN3 diagnosis, or recommendation for a LEEP can leave you with more questions than answers.

We help women understand what their results actually mean, how concerned they should be, and what reasonable options exist for what comes next.

Sometimes that means monitoring. Sometimes it means colposcopy. Sometimes treatment such as LEEP is clearly the right choice. And in carefully selected situations, other approaches may be worth discussing.

Our goal is not to talk you into—or out of—a procedure. Our goal is to help you make the right decision for your situation.

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You have the results. Now what?

Cervical screening can become confusing very quickly.

HPV. ASC-US. LSIL. HSIL. CIN1. CIN2. CIN3. ECC. Positive margins.

Sometimes several results even seem to contradict one another.

The important first step is usually not choosing a treatment. It is understanding the complete picture.

We look at your current results together with your previous Pap tests, HPV testing, biopsies, colposcopy findings, prior procedures, reproductive plans, and other relevant history to help answer three questions:

Where am I now?

How concerned should I be?

What should I do next?

Where are you in the process?
I just got an abnormal Pap or HPV result
You may have been told you need repeat testing, a colposcopy, or simply that something was “abnormal”—without really understanding what that means. Learn what your result means, how HPV fits into the picture, and what usually determines the next step.
I was diagnosed with CIN2, CIN2-3, or CIN3
CIN2 and CIN3 are both high-grade cervical dysplasia, but they do not always lead to the same management. CIN2 can sometimes be observed in carefully selected patients, while CIN3 should be treated. If your pathology says CIN2-3 or HSIL, understanding exactly what the biopsy showed can be especially important before deciding what comes next.
I was told I need a LEEP
Sometimes a LEEP is clearly the right next step. Sometimes there is more to discuss. If you understand the recommendation but are still wondering, “Do I really need this?”, we can review the complete picture before you make a treatment decision.
I want a second opinion before treatment
You do not have to disagree with your current doctor to want another opinion. If you have been told you need a LEEP, another biopsy, closer surveillance, or another procedure and want to better understand the recommendation first, we can review the complete picture and help you understand your reasonable options.
I need a colposcopy
Colposcopy is an important diagnostic examination, but many women arrive anxious because they do not know what will happen—or because of a difficult previous experience. Our approach emphasizes careful evaluation, clear explanation, thoughtful pacing, and attention to your comfort throughout the procedure.
I already had a LEEP or other treatment
Positive margins, persistent high-risk HPV, recurrent CIN, or another abnormal result after treatment can make the next decision more complicated. Instead of looking at the newest result in isolation, we review the entire sequence of testing and treatment.
My HPV test is still positive after treatment
A positive HPV test after LEEP does not automatically mean your treatment failed. But persistent high-risk HPV does matter when estimating future risk and determining the appropriate surveillance plan.
I’m concerned about future pregnancy
Preventing cervical cancer comes first. But when more than one clinically reasonable management strategy exists, future pregnancy and the amount of cervical tissue removed can appropriately be part of the discussion.
How We Can Help

Our goal is to help you understand your results, your level of risk, and the reasoning behind your options — so you can move forward with clarity and confidence.
What Services We Offer:

  • CONSULTATION & SECOND OPINION

    Sometimes the most useful next step is simply putting all of the information together. We review your available Pap, HPV, colposcopy, pathology, and previous treatment records and help you understand. A second opinion does not mean we will necessarily recommend something different. Sometimes the most useful second opinion is confirmation that the plan you were already given is the right one. Consultation / Second Opinion — $350

  • GENTLE COLPOSCOPY

    A high-quality colposcopy requires careful evaluation of the cervix and appropriate biopsy when indicated. But technical quality and patient experience are not competing goals. We take time to explain what we are doing, discuss previous difficult examinations, use thoughtful speculum selection and pacing, and take pain or discomfort seriously. Colposcopy — $350 + pathology fees

  • IMIQUIMOD TREATMENT

    Imiquimod is an immune-response medication that has been studied as a nonsurgical treatment for cervical high-grade squamous intraepithelial lesions. Clinical trials show that some CIN2/3 lesions regress during treatment, but imiquimod is not FDA-approved for cervical dysplasia, is less effective overall than excisional treatment, and is not considered standard U.S. guideline-based treatment for cervical HSIL. For carefully selected patients, we may discuss the published evidence, its limitations, and whether an off-label approach is reasonable to consider.

What if this isn’t your first abnormal result?

Cervical dysplasia can become much more complicated after treatment.

Maybe your LEEP had positive margins.

Maybe your first follow-up HPV test is still positive.

Maybe HPV became positive again later.

Maybe a repeat biopsy shows CIN2 or CIN3.

Or maybe you have already undergone more than one cervical procedure and have been told you need another.

At that point, the question should not automatically become:

“When do we do another LEEP?”

We want to understand the whole sequence:

  • What was originally found?
  • What treatment was performed?
  • What did the pathology show?
  • Which margins were involved?
  • What has happened to HPV testing?
  • What does the cervix look like now?
  • How many procedures have already been performed?
  • Is another excision technically and clinically appropriate?
  • Do future pregnancy concerns affect the decision?

Worried about future pregnancy?

Most women treated for cervical dysplasia can go on to become pregnant.

But cervical treatment and future pregnancy deserve a more nuanced discussion than either:

“LEEP doesn’t matter.”

or

“Never let anyone touch your cervix.”

Neither is accurate.

Research suggests that deeper and repeated cervical excisions are associated with increasing risk of preterm birth, while women with cervical dysplasia may also have some increased baseline obstetric risk independent of treatment.

The practical goal is straightforward:

Treat disease that needs to be treated while preserving unnecessary cervical tissue whenever it is clinically safe to do so.

That can be especially relevant when deciding how to manage CIN2-3 or recurrent disease.

What happens when you come here?

1. Start with your results

Tell us what you have been told and send the Pap, HPV, colposcopy, pathology, or previous procedure records you already have.

2. We review the history

We look at the sequence of results rather than treating one isolated report as the entire story.

3. Meet for evaluation

We explain what your results mean and determine whether an examination or colposcopy is needed.

4. Understand your options

We discuss established recommendations, reasonable alternatives when they exist, benefits, limitations, and tradeoffs.

5. Make a plan

Your plan may involve surveillance, colposcopy, treatment, additional diagnostic evaluation, or referral.

6. Know what happens next

You should leave knowing what happens next, when it happens, and what findings would cause the plan to change.

 

Traveling to Chattanooga for Cervical Dysplasia Care

We see patients who travel to Chattanooga for cervical dysplasia evaluation and selected treatment.

For patients traveling from outside the area, reviewing available records before the visit can help determine what may need to happen in person and make the visit more useful.

An in-person examination is particularly important when treatment options depend on the anatomy of the cervix, visibility of the transformation zone, location of a lesion, or endocervical findings.

Travel to see us

Beyond the LEEP Services Pricing

  • Consultation: $350
  • Colposcopy: $350 + pathology fees (usually $50-$100)
  • Topical Imiquimod Treatment: $2200 + pathology fees (usually $50-$100)

Members of Hitchcock Family Medicine do receive additional discounts on cervical dysplasia services. For more information on becoming a member, click here.

Meet Dr. Matthew Hitchcock

Focused, thoughtful care for cervical dysplasia

Matthew Hitchcock, MD, MBA is a board-certified family physician with a focused clinical practice in cervical dysplasia, colposcopy, and the evaluation of abnormal cervical cancer screening results.

He regularly sees women with abnormal Pap tests, persistent high-risk HPV, CIN1, CIN2, CIN3, and abnormal results after previous cervical treatment. He also provides second-opinion consultations for women who have been told they need a LEEP or another procedure and want to better understand their diagnosis and the options available to them.

Dr. Hitchcock’s approach is deliberately unhurried.

A cervical dysplasia visit is not simply about deciding whether to perform a procedure. It is about reviewing the complete history, looking carefully at the cervix, understanding the pathology, considering future pregnancy goals when relevant, and deciding together what approach makes the most sense.

Sometimes that means surveillance.

Sometimes it means treatment with a LEEP or another excisional procedure.

And in carefully selected situations, it may mean discussing a cervix-preserving or nonsurgical approach.

The goal is not to avoid treatment when treatment is needed. It is to make sure the treatment fits the patient and the disease.

“I want you to understand what we know, what we don’t know, and why I’m recommending what comes next.”

Dr. Hitchcock sees patients in Chattanooga, Tennessee, including women who travel from outside the region for cervical dysplasia consultations and treatment.

Schedule a cervical dysplasia consultation

 

Frequently Asked Questions
Is cervical dysplasia cancer?
No. Cervical dysplasia means abnormal cells are present on the surface of the cervix. High-grade dysplasia can develop into cervical cancer over time, which is why appropriate surveillance or treatment matters. If your results suggest invasive cervical cancer, we do not treat cervical cancer here and will recommend appropriate specialist evaluation.
Is cervical dysplasia caused by HPV?
Almost all cervical precancer is associated with persistent infection with high-risk types of human papillomavirus. HPV is extremely common. A positive HPV result does not by itself tell us that you have precancer or cancer. Your HPV result has to be interpreted together with cytology, biopsy findings, previous testing, and other clinical information.
What makes your approach different?
We take time to review your Pap, HPV, colposcopy, and pathology results carefully, then explain your actual risk in plain language. Our approach emphasizes comfort, dignity, shared decision-making, and evidence-based care, so you understand the safest options before moving forward with monitoring, colposcopy, treatment, or referral.
Do I really need a LEEP?
Sometimes yes. For many patients with high-grade cervical dysplasia, LEEP is an effective and appropriate treatment. But CIN2 and CIN3 are different, and not every cervical abnormality requires immediate excision. If you have been told you need a LEEP and do not understand why, we can review your results and help you understand the recommendation.
Do You Treat Cervical Cancer
No. We do not treat cervical cancer. If your results suggest cancer or a condition that requires specialist care, we will help you understand the concern and coordinate referral to the appropriate gynecologist or gynecologic oncologist.
Do you offer second opinions?
Yes. Many patients come to us after being told they need a colposcopy, LEEP, another biopsy, or closer surveillance and simply want to understand the reasoning before moving forward.
Do I have to be a Hitchcock Family Medicine patient?
No. The cervical dysplasia clinic is available to patients who are not members of Hitchcock Family Medicine. Services are cash-priced, with pricing provided up front.
You don’t need to know which service you need.
If you’ve received an abnormal Pap, positive HPV test, CIN2 or CIN3 diagnosis, recommendation for LEEP, or a new abnormal result after treatment, start with the information you already have. You send us your results. We’ll help you figure out the next question.

Written and medically reviewed by Matthew Hitchcock, MD
Board-Certified Family Physician
Last reviewed: August 26, 2026

Colposcopy Second Opinion Imiquimod CIN2-3 Traveling

Have cervical dysplasia results and not sure what comes next?

You do not need to know exactly what kind of appointment or treatment you need before contacting us.

If you have an abnormal Pap or HPV result, need a colposcopy, have been diagnosed with CIN1, CIN2, or CIN3, have been told you may need a LEEP, or want a second opinion about your options, start with the results you already have.

Our team will review your request and help you understand the appropriate next step.

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