Colposcopy Standards: Guidelines for Endocervical Curettage at Colposcopy

Area of Science:

• Gynecology
• Oncology
• Cervical Cancer Screening

Background:

• The 2017 Colposcopy Standards Consensus Guidelines in the US did not include recommendations for endocervical curettage (ECC).
• Previous guidelines for ECC were established in 2012.
• An expert workgroup convened in 2021 to update ECC guidelines.

Purpose of the Study:

• To provide updated guidelines for the use of endocervical curettage (ECC) in patients referred for colposcopy.
• To incorporate recent literature and data into ECC recommendations.

Main Methods:

• A systematic literature review was conducted for studies published between 2012 and 2021.
• Data from the NCI Biopsy study were analyzed.
• An expert workgroup developed consensus guidelines based on the reviewed literature and data.

Main Results:

• ECC is recommended for patients with high-grade cytology, HPV 16/18 infection, positive p16/Ki67 dual staining, prior cervical precancer treatment, or when the squamocolumnar junction is not visualized.
• ECC is preferred for nonpregnant patients over 40 years old.
• ECC may be omitted in specific cases, such as planned excisional procedures or in young, nulliparous patients with low-grade cytology, but is unacceptable in pregnancy.

Conclusions:

• These updated guidelines for ECC supplement the 2017 colposcopy practice recommendations.
• The guidelines aim to optimize the use of ECC in cervical cancer screening and management.