Using history and colposcopy to select women for endocervical curettage. Results from 2,287 cases.
OBJECTIVE
To enhance the yield of endocervical curettage (ECC) by defining risks for abnormality.


METHODS
Demographic and medical information collected at colposcopy and subsequent histology were reviewed retrospectively. Statistical analysis was by t and chi 2 tests.


RESULTS
Among 2,287 women undergoing ECC at colposcopy, in only 105 (5%) did positive ECC require excisional therapy that would not otherwise have been recommended. Women with positive ECC were older (mean, 39.0 vs. 33.2 years; P < .001) and of higher parity (mean, 3.0 vs. 2.0 births; P < .001), with earlier first intercourse (at 16.6 vs. 17.2 years, P = .006), more unsatisfactory colposcopy (148 [27%] of 545 women with unsatisfactory colposcopy vs. 183 [12%] of 1,523 women with satisfactory colposcopy; P < .001) and more colposcopic impressions of cervical intraepithelial neoplasia (CIN) 2-3 (163 [51%] of 323 vs. 443 [25.6%] of 1,730 women with low grade or a negative impression; P < .001). The likelihood of missed CIN 2-3 was 0.4%, with no missed cancers among women with satisfactory colposcopy and either a normal colposcopic impression (1/254) or nulliparity (2/474).


CONCLUSIONS
ECC identifies otherwise-undetected preinvasive and invasive lesions but may be avoided in women with satisfactory colposcopy who are nulliparous or have no colposcopic lesions.
Massad
L Stewart
LS
Division of Gynecologic Oncology, Departments of Obstetrics and Gynecology, Rush Medical College, Cook County Hospital, Chicago, Illinois, USA. lsmassad@ameritech.net
Collins
Yvonne C
YC
D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D003127:Colposcopy / Q000379:methods*; D004107:Dilatation and Curettage / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008487:Medical History Taking / Q000706:statistics & numerical data*; D008875:Middle Aged; D018579:Patient Selection; D011230:Precancerous Conditions / Q000473:pathology*; D015995:Prevalence; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology*