Patients who have a single-grade discrepancy may be at increased risk for undetected endocervical dysplasia, but these patients could be followed up with Pap smears using an endocervical brush, since the endocervical brush has been shown to be more sensitive than ECC in the detection of endocervical dysplasia. Also, it can be done in an office setting using only local anesthesia. Routine ECC has been justified on the basis that it is the sole indicator of invasive disease in a small subset of patients. It is prudent to further evaluate all cases of abnormal cervical cytology and inadequate colposcopy. ECC is not warranted in such cases, since it will not alter management.
Endocervical curettage is an uncomfortable and costly procedure.
Limiting the use of ECC could significantly decrease the overall cost of evaluation without compromising patient care. In conclusion, given the low probability of pathologic findings, ECC can be omitted in the evaluation of patients with Pap smear findings suggestive of CIN I and an adequate colposcopic examination. The cryosurgical therapy of cervical intraepithelial neoplasia. The value of endocervical curettage in the management of the patient with abnormal cervical cytologic findings. The role of endocervical curettage in the management of patients with abnormal cervical cytology.