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Comparing Endocervical Curettage and Endocervical Brush at Colposcopy.

Dunn, Terry S. MD; Stevens-Simon, Catherine MD; Moeller, Loralie D. MD; Miekle, Susan MD
Journal of Lower Genital Tract Disease: April 2000

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).

Materials and 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.

Conclusion. This study suggests that ECB can replace ECC during colposcopic evaluation of an abnormal Papnicolaou smear.[black small square]

(C)2000The American Society for Colposcopy and Cervical Pathology