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Am J Obstet Gynecol. 2010 Nov;203(5):481.e1-9. doi: 10.1016/j.ajog.2010.06.048. Epub 2010 Aug 30.

Detection of cervical cancer and its precursors by endocervical curettage in 13,115 colposcopically guided biopsy examinations.

Author information

  • 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Rockville, MD 20892, USA. gagej@mail.nih.gov

Abstract

OBJECTIVE:

Endocervical curettage (ECC) specimens obtained during colposcopy can detect cervical cancer and precursors otherwise missed by biopsy alone, but the procedure can be painful and reduce compliance with needed follow-up. ECC is routinely performed in the Calgary Health Region colposcopy clinics, permitting a look at its real-world utility.

STUDY DESIGN:

We analyzed pathology and colposcopy reports from 2003 to 2007. We calculated the added diagnostic utility of ECC compared with cervical biopsy alone.

RESULTS:

ECC increased the diagnostic yield of cervical intraepithelial neoplasia grade 2 or worse (cervical intraepithelial neoplasia [CIN]2+) in 1.01% of 13,115 colposcopically guided biopsy examinations. Therefore, 99 ECC specimens were taken to detect 1 additional CIN2+. ECC detected 5.4% of 2443 CIN2+ subjects otherwise missed by biopsy alone. Utility was greatest among women aged 46 years or older referred after a high-grade cytology.

CONCLUSION:

ECC is rarely informative when used routinely in colposcopic practice. Older women referred after high-risk cytology benefit most from ECC.

Published by Mosby, Inc.

PMID:
20800216
[PubMed - indexed for MEDLINE]
PMCID:
PMC2975767
Free PMC Article
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