Cervical polyps: evaluation of routine removal and need for accompanying D&C

• Published in: Archives of gynecology and obstetrics 2011-03, Vol.283 (3), p.581-584
• Main Authors: Esim Buyukbayrak, Esra, Karageyim Karsidag, Ayse Yasemin, Kars, Bulent, Sakin, Onder, Ozyapi Alper, Ayse Gul, Pirimoglu, Meltem, Unal, Orhan, Turan, Cem
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - epidemiology; Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Dilatation and Curettage; Endocrinology; Endometrial cancer; Endometrial Hyperplasia - diagnosis; Endometrial Hyperplasia - epidemiology; Endometrial Hyperplasia - pathology; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - epidemiology; Endometrial Neoplasms - pathology; Female; General Gynecology; Gynecology; Health risk assessment; Human Genetics; Humans; Medicine; Medicine & Public Health; Middle Aged; Obstetrics/Perinatology/Midwifery; Pathology; Polyps; Polyps - epidemiology; Polyps - pathology; Polyps - surgery; Retrospective Studies; Treatment Outcome; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Young Adult
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-010-1405-5

Objective To estimate prevalence of malignancy and dysplasia in cervical polyps and to judge whether cervical polyps need to be removed routinely. Also to investigate if a cervical polyp is an indicator of endometrial pathology and to assess the necessity of performing dilatation and curettage (D&C). Materials and methods We retrospectively reviewed hospital records of 4,063 cervical polyp cases. Patients’ age, menopausal status and pathological findings were recorded. Descriptive statistics, Pearson’s χ 2 , Fisher’s exact test were used for statistical analysis. P value of ≤0.05 was accepted significant. Results Among 4,063 cervical polyps, only 3 (0.1%) cases of malignancy were encountered which were metastasis from endometrium. There were also dysplastic (0.4%), metaplastic (2.1%), inflamatory (1%) changes. Accompanying endometrial pathologies were: endometrial cancer (0.3%), hyperplasia without atypia (1.3%), endometrial polyp (6.6%). There was statistically significant relation between menopausal status and malignancy of cervical polyps ( P  = 0.055) malignancy of endometrial cavity ( P  = 0.0001). Conclusion Routine removal of cervical polyps, although not mandatory, seems clinically prudent because pathological evaluation is needed to confirm the diagnosis and to rule out other possibilities. 10.9% of postmenopausal patients and 7.8% of premenopausal patients were diagnosed with any endometrial pathology accompanying cervical polyp. Therefore, cervical polyps can be a sign of endometrial disease, especially in postmenopausal women with cervical polyp endometrium should be evaluated more carefully.