Is Removal of Asymptomatic Cervical Polyps Necessary? Histologic Findings in Asymptomatic Israeli Jewish Women

Goldshmid, Oran; Schejter, Eduardo; Kügler, Daniel; Menczer, Joseph

doi:10.1097/lgt.0b013e318225e8bb

Cited by 11 publications

(6 citation statements)

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“…In a previous study a higher incidence of dysplasia (2.6%) and atypical/malignancy (0.30%) among patients with cervical polyps, which is almost similar to the findings of another author [17,18]. A study in 2011 also analyzed 228 cervical polyps and detected dysplasia in 6 (2.6%) cases without any evidence of malignancy [19]. Table 4 shows the frequency of dysplasia and malignancy in cervical polyps reported by previous studies.…”

Section: Discussionsupporting

confidence: 84%

“…They detected cervical dysplasia on cervical cytology only in 1 case (0.4%) in premenopausal women [21]. This result was lower than the incidence (2.6%) found in 2 other studies [18,19]. One of the author reported that the majority of the patients with abnormal previous or concurrent Pap test results had benign endocervical polyps without an evidence of dysplasia or malignancy [18].…”

Section: Discussionmentioning

confidence: 87%

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Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study

et al. 2020

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Objective To determine the frequency of premalignant and malignant lesions in cervical polyps in order to examine whether cervical polyps need to be removed routinely and also to appraise its association with cervical smear cytology and endometrial pathologies. Methods We retrospectively reexamined the hospital records of 299 cases over a period of 5 years. All patients were segregated into perimenopausal and postmenopausal groups according to their menopausal status. The groups were compared in terms of histological results of cervical polyp biopsy, endometrial pathologies, and cervical smear cytology. Pearson's χ 2 test and Fisher's exact test were used for statistical analysis, and a P-value of <0.05 was accepted as statistically significant. Results In the histopathological reports of cervical polyps, premalignant lesions were found in 2% of cases, and only 0.3% of malignant lesion was observed in menopausal women. Subsequently, no malignancy was noted in cervical smear cytology for both groups. Premalignant and malignant lesions in endometrial histopathology findings were 1.33% and 0.66%, respectively. There was a statistically significant association between the menopausal status of the patient and cervical smear cytology and endometrial pathology, but the histological findings were not statistically significant in relation to the symptomatic status of the patients. Conclusion As per the results, we strongly suggest the removal of all cervical polyps with subsequent histological review. The evaluation of cervical smear cytology prior to polypectomy can provide information about its malignancy potential. We believe that along with cervical polypectomy, endometrial sampling should be recommended, especially for postmenopausal women.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 87%

Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study

et al. 2020

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“…With cervical cancer not being detected in any of the women with endocervical polyps, when all HR HPV-positive patients were compared, an endocervical polyp was not found to be significantly associated with a higher risk for preinvasive cervical diseases. Similar to our findings, in a study evaluating 228 women with asymptomatic cervical polyps, invasive cancer was not detected in any of the polyps despite a high rate of cervical cytology abnormalities (29.8%) [7]. Based on the results of our study, some may hypothesize that endocervical polyps are not associated with increased risk of preinvasive or invasive cervical diseases.…”

Section: Conflict Of Interestsupporting

confidence: 90%

Endocervical polyps in high risk human papillomavirus infections

et al. 2022

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Objectives: Human papillomavirus (HPV) positive patients with and without endocervical polyps is compared with respect to HPV genotypes and presence of pre-invasive diseases. To our knowledge, this is the first and largest report in the literature examining the endocervical polyps in HPV positive cases.Material and methods: Clinicopathological data for the first one million screening patients (n = 1 060 992) from around the entire country during 2015 and 2016 were targeted for this research. Colposcopy, colposcopic surgical diagnostic procedures and final pathology results of 3499 patients with high-risk (HR) HPV-positive were obtained from reference colposcopy centers. Patients with endocervical polyps (n = 243 [6.9 %]) were accepted as experimental arm while patients without any endocervical polyp (n = 3256 [93.1%]) were regarded as the control group. Age, HPV genotype, Pap smear abnormality, and final pathological results were compared between two groups using Student's t-test and cross-tabulation chi-square test. Results:The incidence of endocervical polyp was found to be 6.9 % in HR HPV-positive women. The most common HPV genotypes observed in both groups were HPV 16 or 18. Abnormal cytology reports (≥ ASC-US) were not significantly different between both groups. However, with respect to final pathological diagnosis, patients with endocervical polyp had significantly lower numbers of pre-invasive diseases (31.3% vs 44.2%; p < 0.10).Conclusions: Endocervical polyps may be more common in patients with HR HPV infections. HPV 18 is observed significantly more, in the HR HPV positive endocervical polyp group. Patients with endocervical polyps do not have increased risk for preinvasive cervical diseases.

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“…In the absence of practice guidelines from professional societies, reliance is placed on conclusions from published studies. These conclusions vary considerably, including expectant management in select cases [9][10][11], polypectomy [12], polypectomy under colposcopic visualization [13], polypectomy with endocervical curettage [14], polypectomy with hysteroscopy [2,6], and polypectomy with endocervical and endometrial curettage [4]. Most of these strategies for nonpregnant women are in sharp contrast to recommendations made for management of cervical polyps in pregnancy, which recognize that polypectomy should be reserved for situations in which the risk of malignancy is high [15,16].…”

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confidence: 99%

Asymptomatic Cervical Polyps: Can We Just Let them Be?

Nelson

Papa

Ritchie

2015

Womens Health (Lond Engl)

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Aim: Routine polypectomy is still practiced in many settings. The objective of this study was to establish the frequency of dysplasia or malignancy found in cervical polyps from a multiyear sample after abnormal specimens performed for indication were excluded. Materials & Methods: This is a retrospective study of the pathology results from 2006-2013, inclusive. Results: The study included 898 polyps from 854 nonpregnant women, after the 17 abnormal specimens from women who presented with complaints of abnormal bleeding or for evaluation of abnormal cytological tests were excluded; none of the 898 specimens showed any significant abnormalities. The results did not vary by patient age or polyp size. Conclusion: Routine removal of cervical polyps in asymptomatic women with current, normal cervical cytology testing is unwarranted because it adds little to their management and it has the potential to cause harm.

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Is Removal of Asymptomatic Cervical Polyps Necessary? Histologic Findings in Asymptomatic Israeli Jewish Women

Abstract: : The very low frequency of neoplasia in cervical polyps of asymptomatic patients seems to support the notion that there is no clear indication for polypectomy when cytology is normal.

Cited by 11 publications

References 10 publications

Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study

Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study

Endocervical polyps in high risk human papillomavirus infections

Asymptomatic Cervical Polyps: Can We Just Let them Be?

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