Endometrial cells identified in cervical cytology in women ≥40 years of age: criteria for appropriate endometrial evaluation

Objective: 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, ≥40 years of age, positive for BECs on cervical cytology. Study Design: 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. Results: Of 194,717 records examined, 1784 (0.9%) of women ≥40 years had BECs present and 440 had follow-up endometrial pathology. There were 4 cases of complex hyperplasia with atypia, 2 from patients ≤50 years, 1 was asymptomatic; 4 cases of adenocarcinoma were identified, all from women >50 years. Conclusion: 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 ≤50 years.