Colposcopically directed biopsy, random cervical biopsy, and endocervical curettage in the diagnosis of cervical intraepithelial neoplasia II or worse

Am J Obstet Gynecol. 2004 Aug;191(2):430-4. doi: 10.1016/j.ajog.2004.02.065.


Objectives: The purpose of this study was to determine the relative importance of colposcopically directed biopsy, random biopsy, and endocervical curettage (ECC) in diagnosing > or =cervical intraepithelial neoplasia (CIN) II. Study design During a screening study, 364 women with satisfactory colposcopy and > or =CIN II were diagnosed. All colposcopically detected lesions were biopsied. If colposcopy showed no lesion in a cervical quadrant, a random biopsy was obtained at the squamocolumnar junction in that quadrant. ECC was then performed.

Results: The diagnosis of > or =CIN II was made on a colposcopically directed biopsy in 57.1%, random biopsy in 37.4%, and ECC in 5.5% of women. The yield of > or =CIN II for random biopsy when cytology was high grade (17.6%) exceeded that when cytology was low grade (2.8%). One of 20 women diagnosed solely by ECC had invasive cancer.

Conclusion: Even when colposcopy is satisfactory, ECC should be performed. If cytology is high grade, random biopsies should be considered.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy
  • Cervical Intraepithelial Neoplasia / pathology*
  • Colposcopy
  • Dilatation and Curettage
  • Female
  • Humans
  • Middle Aged
  • Uterine Cervical Neoplasms / pathology*