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Related Experiment Videos

Current dilatation and curettage practice: a need for revision.

J J Smith, H Schulman

    Obstetrics and Gynecology
    |April 1, 1985
    PubMed
    Summary

    Routine dilatation and curettage (D&C) for abnormal uterine bleeding has a low yield for detecting uterine cancer, especially in women under 50. Current practices should be re-evaluated and simpler diagnostic methods considered.

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    Area of Science:

    • Gynecology
    • Oncology
    • Diagnostic Procedures

    Background:

    • Abnormal uterine bleeding is a common gynecological complaint.
    • Diagnostic dilatation and curettage (D&C) is a traditional procedure for evaluating uterine pathology.
    • The diagnostic yield of D&C for uterine cancer in various age groups requires further clarification.

    Purpose of the Study:

    • To evaluate the diagnostic yield of dilatation and curettage (D&C) for uterine cancer.
    • To analyze the incidence of premalignant and malignant findings in relation to patient age.
    • To assess the effectiveness of routine D&C in diagnosing uterine malignancies.

    Main Methods:

    • A ten-year retrospective review of 1383 diagnostic dilatation and curettages (D&C) procedures.
    • Analysis of pathological findings stratified by patient age groups.
    • Statistical evaluation of cancer detection rates and significant pathological findings.

    Main Results:

    • Uterine cancer detection did not significantly increase until after age 50.
    • No significant pathological findings were observed in 60% of women until age 70.
    • Premalignant tissue incidence peaked at 16% in women aged 45-49, compared to 4% in those 29 or younger.

    Conclusions:

    • Routine D&C for abnormal uterine bleeding yields few cancer diagnoses.
    • The indications for D&C should be reduced or replaced with simpler diagnostic methods.
    • Age-specific analysis is crucial for optimizing diagnostic strategies in abnormal uterine bleeding.

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