• Ibrahim Gulhan, Raziye Özdemir, Alper İleri, Hande İleri, Sena Özcan, Ayse Betül Öztürk, Mehmet Gökçü, and Mehmet Özeren.
• From the Department of Obstetrics and Gynecology, Ministry of Health Health Sciences, University Izmir Tepecik Education and Research Hospital, Konak, Ïzmir, Turkey.
• Ann Saudi Med. 2024 Jul 1; 44 (4): 220227220-227.

BackgroundThe role of endocervical curettage (ECC) in the diagnosis of cervical intraepithelial neoplasia (CIN) is a controversial topic.ObjectivesInvestigate the role of ECC in the diagnosis of CIN in human papillomavirus (HPV) positive patients.DesignRetrospective.SettingA tertiary training and research hospital.Patients And MethodsThis study included patients who were referred for colposcopy between 2018-2022 because of abnormal screening results. ECC results, age, cytology, HPV status, and colposcopic impression of the patients were extracted from the medical records. Multinomial logistic regression analyses were performed to identify factors that could predict CIN on ECC.Main Outcome And MeasuresThe likelihood of high-grade squamous intraepithelial lesions (HSIL) in ECC in patients with cervical biopsy results of normal and low-grade squamous intraepithelial lesion (LSIL).Sample Size2895 women.ResultsIn patients with normal and LSIL cervical biopsy results, HSILs were detected in 6.7% of ECC results. There was no difference in the detection rates of CIN in ECC among groups with smear results negative for intraepithelial lesions or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US), and LSIL. The likelihood of HSIL being observed in ECC was 2.2 times higher in patients with HPV16. The probability of LSIL disanois was 2.3 times higher in women aged 50-59 years and 2.8 times higher in women ≥ 60 years compared to the reference group of <30 years. The probability of LSIL was 2.3 and HSIL by ECC was 2.2 times higher in both age categories (P<.012 and P=.032, respectively) than the reference group of <30 years.ConclusionRegardless of colposcopic findings, ECC should be performed in patients with smear results of NILM who are positive for HPV16, in patients with smear results of ASC-US and LSIL who are positive for any oncogenic type of HPV and in patients 50 and above with any result of smear or any oncogenic HPV type.LimitationsWe did not have the components of the HPV types in mixed groups.

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