Endocervical curettage when colposcopic examination is satisfactory and normal

Area of Science:

• Gynecology
• Cervical Pathology
• Colposcopy

Background:

• Cervical cytology screening identifies women with squamous intraepithelial lesions (SIL) or atypical squamous cells of undetermined significance (ASCUS).
• Colposcopy is used to evaluate abnormal cervical cytology, with endocervical curettage (ECC) sometimes performed to assess the endocervix.

Purpose of the Study:

• To determine the incidence of endocervical dysplasia in women with ASCUS or low-grade SIL and a normal colposcopic examination.
• To evaluate the necessity of endocervical curettage in this specific patient population.

Main Methods:

• A retrospective review of an electronic colposcopy database identified 159 women meeting specific criteria for cervical cytology and colposcopy.
• Exclusion criteria included pregnancy, abnormal colposcopy, postmenopausal status, and recent cervical treatment.
• Women with consecutive ASCUS, ASCUS favor SIL, or low-grade SIL and a satisfactory, normal colposcopy were included.

Main Results:

• Only 2.5% of women had dysplastic cells in their endocervical curettings.
• Endocervical dysplasia was confirmed in only 0.63% of the study group.
• Mild dysplasia was found in the transformation zone in three women, with one case suspected to be contamination.

Conclusions:

• The incidence of endocervical dysplasia is very low in women with ASCUS or low-grade SIL and a normal colposcopy.
• Endocervical curettage may be safely omitted in women with ASCUS or low-grade SIL and a satisfactory, normal colposcopic examination.
• This finding could help streamline cervical cancer screening protocols and reduce unnecessary procedures.