Objective: To evaluate and compare the cytologic information obtained
from the endocervical brush and the histologic information obtained fr
om the standard endocervical curettage (ECC) used to evaluate the endo
cervical canal in patients with an abnormal Papanicolaou test. Methods
: Three hundred eighty-eight patients underwent evaluation of an abnor
mal Papanicolaou test with a repeat Papanicolaou test, a separate endo
cervical brush test, colposcopy, directed biopsies, and ECC. The study
group comprised 101 patients who subsequently underwent conization an
d/or hysterectomy. The brush and ECC results were evaluated against th
e final pathologic findings. Results: Sixty-five patients had a satisf
actory colposcopy and 36 had an unsatisfactory colposcopy. Results for
these two groups are reported separately. For the total group, the se
nsitivities of the ECC and brush were 49 and 93%, respectively (P < .0
01); the specificities were 82 and 26% (P < .001), the positive predic
tive values were 69 and 52% (P = .99), and the negative predictive val
ues were 65 and 82% (P = .004). Conclusion: The endocervical brush app
ears to be a sensitive test for disease in the endocervical canal but
yields a high false-positive rate. The role of the brush in this setti
ng will require further study. The ECC is more specific but is also a
suboptimal test for identifying disease in the endocervical canal.