The value of endometrial cytology by scraping in 1,798 cases: screening in asymptomatic women and diagnosis in symptomatic ones.

A study of 1,798 endometrial cytological samples, obtained with an "endocyte" (a disposable scraping device) and controlled in histology is presented. The method was tested for its usefulness in screening of precancerous lesions and preclinical cancer in 1,248 asymptomatic women and in the diagnosis of endometrial pathology in 550 symptomatic ones. The classification of hyperplasia into benign simplex and complex hyperplasia and atypical hyperplasia was followed; atypical hyperplasia, considered real intraepithelial neoplasia, was included in the positive cases. Histological verification was made chiefly on cell block in asymptomatic cytologically negative cases and either on curettage or hysterectomies in the others. The main endometrial cytological patterns are described. On the basis of findings, considering also endocyte's low cost, effectiveness, and ease of use, we think the method could be usefully employed in screening of endometrial cancer for an asymptomatic population. In symptomatic women, the use of histologic procedures is still preferable, and cytology cannot be considered a "first option" method.