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Open AccessArticle
Evaluation of Endocervical Curettage in Colposcopy in the Turkish Cervical Cancer Screening Program
by
Utku Akgor
Utku Akgor 1,*
,
Nejat Ozgul
Nejat Ozgul 1,
Ali Can Gunes
Ali Can Gunes 2,
Murat Turkyılmaz
Murat Turkyılmaz 3 and
Murat Gultekin
Murat Gultekin 1
1
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University, Faculty of Medicine, Ankara 06100, Turkey
2
Department of Obstetrics and Gynecology, Mamak State Hospital, Ankara 06320, Turkey
3
Department of Cancer Control, Turkish Ministry of Health, Public Health Institute, Ankara 06200, Turkey
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(15), 4417; https://doi.org/10.3390/jcm13154417 (registering DOI)
Submission received: 1 July 2024
/
Revised: 21 July 2024
/
Accepted: 25 July 2024
/
Published: 28 July 2024
Abstract
Background/Objectives: To investigate the risk factors for CIN2+ lesions (cervical intraepithelial neoplasia 3 or worse) in endocervical curettage (ECC) and to evaluate the relationship between the addition of ECC to punch biopsy in terms of the yield of CIN2+ lesions. Methods: Between February 2018 and 2019, data on colposcopy results from 11,944 patients were gathered from the Cancer Department of the Turkish Ministry of Health across the country. A total of 6370 women whom were referred to colposcopy were included in this study. Risk factors were identified using both univariate and multivariate logistic analyses. Results: The median age was 42 years old (range, 30–65). ASC-H (atypical squamous cells-suggestive of high-grade squamous intraepithelial lesion)/HSIL (high-grade intraepithelial lesion) cytology (OR 7.648 95% CI (3.933–14.871)) and HPV (human papillomavirus)-16/18 infection (OR 2.541 95% CI (1.788–3.611)) were identified as risk factors for having CIN2+ lesions. CIN2+ diagnostic yield by ECC is only 1.2% all patients. CIN2+ diagnostic yield by punch biopsy and ECC are 9.7% and 6% of patients, respectively. A higher CIN2+ yield by ECC was observed with increasing age. Among cytology groups, ASC-H/HSIL has highest CIN2+ yield by ECC. Finally, in patients with incomplete visualization of the squamocolumnar junction (SCJ), ECC yields approximately twice as many CIN2+ lesions. Conclusions: ECC should be considered in cases of advanced patient age and in situations where the SCJ is not routinely visualized. In addition, evaluation of the endocervical canal is necessary in HPV-positive cases infected with HPV-16/18 types and in cases infected with HPV of any type but with cytological abnormalities.
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MDPI and ACS Style
Akgor, U.; Ozgul, N.; Gunes, A.C.; Turkyılmaz, M.; Gultekin, M.
Evaluation of Endocervical Curettage in Colposcopy in the Turkish Cervical Cancer Screening Program. J. Clin. Med. 2024, 13, 4417.
https://doi.org/10.3390/jcm13154417
AMA Style
Akgor U, Ozgul N, Gunes AC, Turkyılmaz M, Gultekin M.
Evaluation of Endocervical Curettage in Colposcopy in the Turkish Cervical Cancer Screening Program. Journal of Clinical Medicine. 2024; 13(15):4417.
https://doi.org/10.3390/jcm13154417
Chicago/Turabian Style
Akgor, Utku, Nejat Ozgul, Ali Can Gunes, Murat Turkyılmaz, and Murat Gultekin.
2024. "Evaluation of Endocervical Curettage in Colposcopy in the Turkish Cervical Cancer Screening Program" Journal of Clinical Medicine 13, no. 15: 4417.
https://doi.org/10.3390/jcm13154417
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