Dysplasia and malignancy in endocervical polyps

Objective: The objective was to estimate the prevalence of malignancy or dysplasia in cervical polyps. Methods: A convenience sample was identified by retrospectively searching the Hartford Hospital pathology database for cases of endocervical polyps removed from January 1, 1999, through January 31, 2006. The presence of malignancy, dysplasia, atypia, and other modifiers was recorded along with demographic information, including age, race/ethnicity, residence, and the ordering practitioner. Results: The sample size consisted of 2246 polyps obtained from 2100 women, who ranged in age from 16 to 95 years (mean ± SD, 48.6 ± 10.9). The women were 82.4% white, 3.4% African American, 5.4% Hispanic, 0.4% Asian, and 8.3% other. The majority of women were from private practices (95.2%), and obstetrics/gynecology providers sent 98.3% of the polyp samples. Malignancy was diagnosed in 0.1% of cases. Polyps showed dysplasia in 0.5% of cases, and reactive atypia was seen in 1.6%. Inflammatory changes were seen in 27.7% of polyps, metaplasia in 13.6%, and microglandular hyperplasia in 6.8%. The recurrence rate was 6.2%. Conclusions: The prevalence of malignancy and dysplasia in cervical polyps removed over a 7-year span was 0.1% and 0.5%, respectively. Cervical polyps can harbor disease from sources beyond the cervix. Because there were no cases of primary malignancy in this large series of cervical polyps, it appears unlikely that cervical polyps progress to malignancy. Additionally, polyp recurrence is not uncommon. This information has significant implications as physicians plan appropriate counseling and management for the common diagnosis of cervical polyps.