Agreement Between Endocervical Brush and Endocervical Curettage for the Diagnosis of Cervical Cancer

INTRODUCTION: Endocervical curettage (ECC) and endocervical brush (ECB) are two of the methods that can be used in the diagnosis of cervical cancer, which is one of the most common gynecologic cancer. In this study, the agreement between two methods was investigated and it was evaluated whether ECB can be used instead of ECC, which is more invasive.
METHODS: The files of the patients admitted to the Gynecology and Obstetrics Clinic of a tertiary health care center were retrospectively reviewed. A total of 170 patients who were referred for colposcopy due to abnormal Papanicolaou test (pap smear) result and / or high-risk human papilloma virus (HPV) positivity and who underwent colposcopic biopsy without anesthesia, and cervical sampling with ECC and ECB were included. The ECB and ECC sampling results were divided into 3 groups, as “Negative”, “Low-grade” and “High-grade”.
RESULTS: ECB was negative in 132 (83.5%) of the 158 patients who had negative ECC results. Four patients with low-grade ECC results also had low-grade ECB results (100%). Only 4 patients (50%) had high-grade ECB results of 8 patients with high-grade ECC results. Regarding all the data between the two groups, a moderate degree of agreement was found with an ICC of 0.503 (95% CI: 0.327-0.633, p <0.001).
DISCUSSION AND CONCLUSION: Considering the moderate agreement between the two methods, especially higher in the negative group as well as the low-grade group, and ECB being less invasive, it can be concluded that both methods can be used interchangeably according to patients.