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Diagnostic dilation and curettage: A reappraisal

  • David A. Grimes
    Correspondence
    Family Planning Evaluation Division, Center for Health Promotion and Education, Centers for Disease Control, Atlanta, Georgia 30333
    Affiliations
    From the United States Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Health Promotion and Education, Family Planning Evaluation Division, Atlanta, Georgia
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      Diagnostic dilation and curettage (D&C) is widely considered to be the method of choice for obtaining samples of endometrium for histologic examination, although the scientific basis for this assumption is elusive. Despite extensive use of D&C, the tissue yield and diagnostic accuracy of this technique have not been adequately evaluated. More is known about these features of a newer diagnostic procedure, Vabra aspiration (VA). VA also appears to be safer, less expensive, and more convenient than D&C. Until the alleged benefits of diagnostic D&C can be shown to outweigh its risks and costs (approaching one billion dollars per year in the United States alone), D&C probably should not be the primary procedure used for obtaining most samples of endometrium.
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