Endometrial cytology: six years of experience

This article deals with a 6-yr mass screening program for the early detection of endometrial cancer, which took place 1978-1983. The diagnostic accuracy of endometrial cytology and the possibility of integrating this technique with the hysteroscopy and endometrial biopsy were studied. The authors analyzed 2,504 outpatients, all over the age of 45. The results of endometrial cytology were compared with those found using hysteroscopy and endometrial biopsy. Endometrial cytology showed high sensitivity in diagnosing endometrial cancer (97.7%) and high specificity in diagnosing true negatives. However, this technique was not adequate in identifying benign endometrial pathology, e.g., endometrial hyperplasia, polyps, or submucous fibromas. Epidemiological and clinical data in our series were fundamental in establishing mass screening for the early detection of endometrial cancer using integrated techniques. These data should be taken into consideration for creating new projects. The significantly high prevalence of endometrial neoplasia even in asymptomatic women over 45 years of age (4 per 1000) and the possibility of improving the accuracy of endometrial diagnosis using hysteroscopy and endometrial biopsy were the cornerstones of this project.