Comparison of Sampling Devices for Endocervical Curetting

Area of Science:

• Gynecology
• Cervical Pathology
• Diagnostic Procedures

Background:

• Endocervical curetting (ECC) is crucial for diagnosing glandular lesions when colposcopy is inadequate.
• Pain associated with the traditional curette led to the development of the endocervical brush.
• Optimal ECC device for sample yield and precancer detection remains unclear.

Purpose of the Study:

• Compare sample yield and CIN2+ detection rates of curette, brush, and combined curette-brush for ECC.
• Evaluate the impact of age and parity on ECC sample adequacy and yield.

Main Methods:

• Randomized controlled trial involving 300 women with positive high-risk HPV DNA tests and inadequate colposcopy.
• Women were allocated to ECC using curette, brush, or both devices.
• Histological comparison of samples to determine adequacy and CIN2+ detection.

Main Results:

• The curette and the combined curette-brush yielded significantly more samples than the brush alone.
• No significant difference in CIN2+ detection rates was observed among the three sampling methods.
• Adequacy of samples was not affected by age or parity across the devices.

Conclusions:

• Both the curette and the combined curette-brush are superior to the brush alone for increasing ECC sample volume.
• Cervical precancer (CIN2+) detection is comparable across all evaluated ECC sampling devices.
• Age and parity do not influence the effectiveness of these ECC devices.