Detection of malignancy in endometrium by brush sampling in 1042 symptomatic patients

Endometrial brush samples were taken from 1042 symptomatic hospital patients using Uterobrush(R), and the results were compared either to the histology of the endometrium obtained with dilatation and curettage (n = 313) or the patients' follow-up (n = 729). Only one cancer (100%) among patients 51 years of age (n = 365), 11 (91.7%) were detected by Papanicolaou classes III-V. One cancer was missed, whereas no false positive results were found. The diagnostic accuracy in this group of patients varied from 92.3% to 97.8%, depending on the group (true positive vs true negative) to which the Papanicolaou class III was placed. We conclude that endometrial cytology obtained by brushing is useful for symptomatic patients of all age groups and gives an indication for further examination. If cytology is normal and bleeding continues in postmenopausal patients, curettage is indicated.