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Cone biopsy: has endocervical sampling a role?

D J Anderson¹, F Strachan, D E Parkin

¹Harris Birthright Centre for the Prevention of Cervical Cancer, Aberdeen Royal Infirmary.

British Journal of Obstetrics and Gynaecology

|August 1, 1992

Summary

Endocervical sampling for abnormal cervical smears has low sensitivity (56%) and a high false negative rate (44%). These results suggest that endocervical sampling should not guide management decisions when colposcopy is inconclusive.

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Area of Science:

Gynecologic Oncology
Cervical Cancer Screening

Background:

Abnormal cervical smears necessitate further investigation to accurately diagnose cervical intraepithelial neoplasia (CIN).
Endocervical sampling is a common procedure used to assess the endocervical canal for precancerous or cancerous changes.

Purpose of the Study:

To evaluate the diagnostic accuracy of endocervical sampling methods.
To determine the sensitivity, specificity, and predictive values of endocervical sampling in women with abnormal Pap smears.

Main Methods:

A randomized study comparing the Kevorkian curette and the Medscand endocervical brush for sample collection.
100 women with abnormal cervical smears underwent endocervical sampling followed by cone biopsy.
Cytology and histology results were compared to cone biopsy findings.

Main Results:

Endocervical sampling demonstrated an overall sensitivity of 56%.
The false negative rate was 44%, indicating a significant number of missed diagnoses.
The negative predictive value was 26%, suggesting limited reliability in ruling out disease.

Conclusions:

Endocervical sampling has limited diagnostic value in the context of abnormal cervical smears.
Management decisions, particularly when colposcopy is unsatisfactory, should not be solely based on endocervical sampling results.

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