title: Utility of random cervical biopsy and endocervical curettage in a low-risk population.
abstract: OBJECTIVE
  The study aimed to determine the increase in the yield of cervical intraepithelial neoplasia 3 (CIN 3) or cancer (CIN 3+) from random cervical biopsy in quadrants without visible lesions and endocervical curettage (ECC) in a low-prevalence setting.
  
  
  METHODS
  Random biopsy and ECC (unless pregnant) have been obtained in the colposcopy clinic of the Southern California Permanente Medical Group (SCPMG)-Fontana since 2004. We reviewed the colposcopy experience of SCPMG-Fontana for January 1, 2007, to December 31, 2009, to determine the method of diagnosis of CIN 3+.
  
  
  RESULTS
  Between January 1, 2007, and December 31, 2009, 4677 women with median age 32 years had 4932 colposcopies in the SCPMG-Fontana colposcopy clinics. Cervical intraepithelial neoplasia 3+ was diagnosed in 295 women. Cervical biopsy detected 64.4% of CIN 3+; ECC diagnosed 5.1%; loop electrocautery excision procedure (LEEP) or cervical conization for cervical biopsy and/or ECC of CIN 2 diagnosed 27.8%; LEEP for the cytology of high-grade squamous intraepithelial lesion with cervical biopsy result of negative or CIN 1 diagnosed 1.4%; and LEEP, cervical conization, or biopsy in follow-up of CIN 2 diagnosed 1.4%. Sixty-one of the 295 cases of CIN 3+ (20.7%) were diagnosed after evaluation of random cervical biopsy and/or ECC of CIN 2+.
  
  
  CONCLUSIONS
  Random biopsy in cervical quadrants without visible lesions and ECC increased the yield of CIN 3+ in this low-risk colposcopy setting. Endocervical curettage can be omitted in women younger than 25 years.
authors.affiliation: Department of Obstetrics and Gynecology, Southern California Permanente Medical Group-Fontana, Fontana, CA 92335, USA. Robert.G.Pretorius@kp.org
authors.forename: Robert G
authors.initials: RG
authors.lastname: Pretorius
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Belinson
authors.forename: Faramarz
authors.initials: F
authors.lastname: Azizi
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Peterson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Belinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D002140:California; D003475:Curettage / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*