August 2nd, 2021

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Use and Utility of Endocervical Curettage at Colposcopy
Authors:  Yue Guan, M.D., Quetzal A. Class, Ph.D., and Abigail R. Litwiller, M.D.
  OBJECTIVE: To evaluate endocervical curettage (ECC) at colposcopy for detection of cervical intraepithelial neoplasia (CIN) of 2 or greater as there is limited information on the diagnostic utility of ECC.

STUDY DESIGN: Retrospective chart review of patients receiving colposcopy at a large urban hospital from January 2017 to January 2019 (N=402). We extracted demographics, medical comorbidities, insurance status, pap smear cytology, and HPV and colposcopy results including biopsy or ECC pathology. We used descriptive and χ2 analyses.

RESULTS: ECC was performed in 66.9% of colposcopies, and 7.8% returned with pathology of CIN 2 or greater. Transplant recipients were more likely to have ECC performed [χ2(1, N=402)=7.23, p<0.05] as were those with inadequate colposcopy [χ2(2, N=402)=28.5, p<0.0001]. ECCs were more likely to be performed when cervical biopsy was also performed [74% vs. 58% with no biopsy; χ2(2, N=402)=13.3, p<0.05]. ECC was less frequent with unsatisfactory pap cytology [70% without ECC, χ2(12, N=402)=22.93, p<0.05]. Cervical biopsy CIN results agreed with ECC CIN results [χ2(1, N=151)=20.62, p<0.0001]. In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed CIN 2 or greater.

CONCLUSION: Performance of ECC differed by patient status; however, ECC generally did not change clinical management.
Keywords:  colposcopy; diagnostic tests, routine; early detection of cancer; endocervical curettage; uterine cervical neoplasms, diagnosis
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