title: Comparing endocervical curettage and endocervical brush at colposcopy.
abstract: OBJECTIVE
  To determine the sensitivity and specificity of the cytologic diagnosis obtained from the endocervical brushings (ECB) compared to the histologic information obtained from endocervical curettage (ECC).
  
  
  METHODS
  Of 369 patients referred for colposcopy, 105 nonpregnant women underwent conization and/or hysterectomy allowing analysis of tissue samples. The racially diverse, sociodemographically homogeneous population was 15 through 71 years old. Participants had repeat Papnicolaou smears, ECB, colposcopy (with/without directed biopsy), and ECC. The sensitivity, specificity, and positive and negative predictive values of ECB and ECC for diagnosing endocervical disease were compared.
  
  
  RESULTS
  No invasive cancers were missed by either ECB or ECC. The sensitivity of ECB was 93%, which exceeded that of ECC (62%) for detection of endocervical pathology. However, the negative predictive value of both ECB and ECC was excellent. The specificity of ECC (63%) exceeded that of ECB (25%) for detection of endocervical pathology. However, the positive predictive value of both ECC and ECB was poor.
  
  
  CONCLUSIONS
  This study suggests that ECB can replace ECC during colposcopic evaluation of an abnormal Papnicolaou smear.▪.
authors.affiliation: * Department of Obstetrics and Gynecology, ‡Department of Pediatrics, and † Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, CO; § Center For Disease Control, Division of Reproductive Health, Atlanta, GA.
authors.forename: T S
authors.initials: TS
authors.lastname: Dunn
authors.forename: C
authors.initials: C
authors.lastname: Stevens-Simon
authors.forename: L D
authors.initials: LD
authors.lastname: Moeller
authors.forename: S
authors.initials: S
authors.lastname: Miekle