Abstract
Discussion Forum (0)
Introduction: Few studies have investigated the diagnostic utility of endocervical curettage (ECC) since the 2013 ASCCP Updated Consensus Guidelines. We evaluate the use of ECC at colposcopy for detection of ≥ cervical intraepithelial neoplasia (CIN) two.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Introduction: Few studies have investigated the diagnostic utility of endocervical curettage (ECC) since the 2013 ASCCP Updated Consensus Guidelines. We evaluate the use of ECC at colposcopy for detection of ≥ cervical intraepithelial neoplasia (CIN) two.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Use and Utility of Endocervical Curettage at Colposcopy
Yue Guan
Abstract
Discussion Forum (0)
Introduction: Few studies have investigated the diagnostic utility of endocervical curettage (ECC) since the 2013 ASCCP Updated Consensus Guidelines. We evaluate the use of ECC at colposcopy for detection of ≥ cervical intraepithelial neoplasia (CIN) two.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Introduction: Few studies have investigated the diagnostic utility of endocervical curettage (ECC) since the 2013 ASCCP Updated Consensus Guidelines. We evaluate the use of ECC at colposcopy for detection of ≥ cervical intraepithelial neoplasia (CIN) two.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
Methods: IRB approved retrospective chart review included patients attending colposcopy clinic at a large urban hospital from January 2017 to January 2019 (N=402). From electronic medical records we extracted demographic characteristics, medical comorbidities, insurance status, pap smear cytology, HPV results, and colposcopy results including biopsy or ECC pathology. We used Chi-square to evaluate the use and diagnostic utility of ECC at time of colposcopy for detection of ≥ CIN two.
Results: An ECC was performed in 66.9% of colposcopies and 7.8% of those returned with pathology of ≥ CIN two. Transplant recipients were significantly more likely to have an ECC performed during colposcopy (X2(1, N=402) = 7.23, P < .05) while ECC was less frequent for those with unsatisfactory pap cytology (70% did not receive ECC, P < .001). Inadequate colposcopy was associated with a higher likelihood of receiving ECC (P < .0001). ECCs were significantly more likely to be performed when cervical biopsy was also performed (74% vs 58% with no biopsy; X2(2, N=402, P= < .05). Cervical biopsy CIN results agreed with ECC CIN results (X2(1, N=151) = 20.62, P < .0001). In 4.2% of colposcopies, when cervical biopsy revealed no dysplasia or CIN 1, ECC revealed ≥ CIN 2.
Conclusion/Implications: ECCs were performed more frequently in transplant patients, inadequate colposcopy, and when cervical biopsy was also obtained. In most cases ECC did not change management.
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