Introduction/Background At the end of 2022, meta-analysis driven by Damjkaer and collaborator seemed to have resolved the eternal controversy of whether endocervical brushing, less aggressive than curettage, could be a reliable option for the diagnosis of endocervical pathology hidden from colposcopy.

Although the results were optimistic and encouraged brushing to be promoted, the authors warned of the limitations of their review, which weakened the external validity of their conclusions.

Given the uncertainty created by such conclusions, we decided to evaluate the comparability of both tests in our setting.

Methodology Endocervical brushing and curettage were performed at the same time on all patients who were going to undergo cervical conization during the second half of 2023 in our Center, prior to performing the surgical procedure.

The results of brushing and curettage were compared with respect to the gold standard that involved the anatomopathological study of the conization piece and also with respect to the adequacy of the sample obtained for histological study. Brushing was always done prior to curettage.

Results 90 cases were analyzed. In 8 of them there was endocervical pathology while in 82 the endocervix was free of disease.

There were 52 brushings that did not obtain sufficient material for diagnosis, which also occurred in 12 curettages.

In the 8 cases with endocervical pathology, brushing was not evaluable as sufficient sample was not extracted. The curettage did detect the disease in all 8 cases, but it also led to the incorrect assumption that endocervical pathology existed in another 4 cases.

There are statistically significant differences between the specificity of brushing (50%) and curettage (95%), as well as their ability to obtain a sufficient sample for diagnosis.

Conclusion Although our sample size is limited, endocervical curettage remains a superior diagnostic test to brushing in our setting.

Disclosures No conflict of interest.