Necessity for endocervical curettage in elderly women undergoing colposcopy

A retrospective study of 164 women aged 45 and older undergoing colposcopy for abnormal Papanicolaou smears showed that 49% had adequate colposcopy and 51%, inadequate colposcopy. Of those with adequate colposcopy, 23% had positive endocervical curettage (ECC). That finding required conization, which detected one case of microinvasive and two of invasive cervical carcinoma. Of those with inadequate colposcopy, 64% had positive ECC. All patients with inadequate colposcopy underwent conization, which detected 4 cases of microinvasive and 11 of invasive carcinoma. Therefore, women with inadequate colposcopy had a higher risk of invasive disease. ECC is a necessary step in the colposcopic evaluation of elderly women.