Endometrial cells identified in cervical cytology in women > or = 40 years of age: criteria for appropriate endometrial evaluation.

Abstract

No consensus exists regarding evaluation of asymptomatic premenopausal women with benign endometrial cells (BECs) identified on cervical cytology. We determined the frequency of uterine pathology in asymptomatic women, > or = 40 years of age, positive for BECs on cervical cytology. Cervical cytopathology records from a Midwestern US teaching hospital from April 2002 through December 2005 were reviewed and cases with BECs identified. Patient age, symptomatology, and endometrial sampling results were obtained. Of 194,717 records examined, 1784 (0.9%) of women > or = 40 years had BECs present and 440 had follow-up endometrial pathology. There were 4 cases of complex hyperplasia with atypia, 2 from patients < or = 50 years, 1 was asymptomatic; 4 cases of adenocarcinoma were identified, all from women > 50 years. To date, the present study is among the largest follow-up studies of women with BECs on cervical cytology. Follow-up endometrial sampling may not be indicated in asymptomatic patients < or = 50 years.