Comparison of dysplastic and benign endocervical polyps

OBJECTIVE: This study aimed to estimate dysplasia rate in histologically evaluated endocervical polyps and to compare histological and clinical characteristics of dysplastic (D) polyps with those displaying representative benign changes. MATERIALS AND METHODS: Endocervical polyps removed at Mayo Clinic from January 1994 to December 2010 were categorized as polyp without other descriptors, benign polyp variants, adenomatous or reactive atypical (AR) polyps, and D polyps. Clinical characteristics, cervical cytological result, and polyp histological result of patients in the latter 2 categories were compared. RESULTS: Among the 4,328 patients with endocervical polyps, 3,656 were classified as polyp without other descriptors, 628 as benign polyp variants, 34 as AR polyps, and 9 as D polyps. Dysplasia was mild in 4 polyps, moderate in 1 polyp, and severe in 4 polyps. Overall risk of dysplasia was 0.2%. Patients with D polyps were younger (mean = 40.3 vs. 49.8 years, p = .009) and more likely to have abnormal cervical cytological result before polyp removal (67% vs. 21%, p = .014) as compared with those with AR. Patients with D polyps tended to have a polyp greater than 20 mm (44% vs. 15%, p = .074) compared with those with AR polyps. Associated endometrial pathological diagnosis was limited to a prolapsed endometrial polyp in 1 patient and submucosal endometriosis in 1 patient. CONCLUSIONS: Patients with D polyps were younger and had a greater likelihood of abnormal cytological result before polyp removal. No polyp size threshold below which dysplasia could be excluded was identified. No primary cervical cancer, endometrial hyperplasia, or cancer was identified.