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

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%), inflammatory (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.