Diagnostic Utility of Endocervical Curettage During Colposcopy Among Patients of Varying Risk Factors

Authors

Stephanie M. Wang, Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington DC.
Catherine Hoeppner, Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington DC.
Jamil Kazma, Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington DC.
Emma Keegan, The George Washington University School of Medicine and Health Sciences, Washington DC.
Logan Werner, The George Washington University School of Medicine and Health Sciences, Washington DC.
Nicole P. Chappell, Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington DC.

Document Type

Journal Article

Publication Date

10-1-2022

Journal

Journal of lower genital tract disease

Volume

26

Issue

4

DOI

10.1097/LGT.0000000000000697

Abstract

OBJECTIVE: Endocervical curettage (ECC) during colposcopy is recommended in certain circumstances; however, diagnostic use remains unclear. We evaluate the utility of ECC among patients with non-fully visualized squamocolumnar junction (SCJ) and certain patient socioeconomic factors. METHODS: Retrospective chart analysis was completed for patients aged older than 21 years who underwent a colposcopy at 2 study sites between 2012 and 2021. Demographics and histopathologic results were analyzed. RESULTS: A total of 1,516 colposcopies were reviewed; 73.8% (n = 1,119) had an ECC with colposcopy. Of those, 92.1% (n = 1,031) had benign ECC whereas 13.9% (n = 156) had a positive ECC at time of colposcopy. Most patients with benign ECC had benign/low-grade squamous intraepithelial lesion pathology on colposcopy biopsy (82.3%; n = 914; p < .001), and most patients with high-grade squamous intraepithelial lesion (HSIL) on ECC had HSIL on colposcopy biopsy (63.4%; n = 52; p < .001) However, when looking at patients with high-grade pathology on colposcopy biopsy, it was seen that most had benign or low-grade squamous intraepithelial lesion on ECC (79.5%; n = 205; p < .001). Most patients with adequately visualized SCJ on colposcopy were noted to have HSIL on biopsy and negative ECC (73%; n = 81; p < .001). This result was similar in patients with non-fully visualized SCJ, although not statistically significant. When stratified by socioeconomic status, most patients with high-grade lesions had a benign ECC. CONCLUSIONS: Endocervical curettage has been described to increase the identification of high-grade lesions at time of colposcopy. This descriptive study shows that many high-grade lesions at time of excisional procedure had a benign ECC on colposcopy, with no demonstrated clear additional utility in high-risk groups.

APA Citation

Wang, Stephanie M.; Hoeppner, Catherine; Kazma, Jamil; Keegan, Emma; Werner, Logan; and Chappell, Nicole P., "Diagnostic Utility of Endocervical Curettage During Colposcopy Among Patients of Varying Risk Factors" (2022). GW Authored Works. Paper 1579.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1579

Department

Obstetrics and Gynecology