Approach to cervical polyps in primary care

Objective: To provide primary care providers (PCPs) with an approach for diagnosing and managing endocervical polyps, detailing a procedural technique for cervical polypectomy and outlining key information on when to refer to a gynecologist.

Sources of information: This review and approach are based on the second author's clinical practice and available literature from 1994 to 2023.

Main message: Cervical polyps are commonly asymptomatic and benign, but can cause intermenstrual and postcoital bleeding. Cervical polyps alone are unlikely to be associated with dysplasia or malignancy; routine Papanicolaou and human papillomavirus tests remain the most important factors in identifying cervical dysplasia. For symptomatic patients, the lack of available literature to guide PCPs can result in unnecessary referrals to gynecology, long wait times, and associated costs to the health care system. Symptomatic endocervical polyps can be easily and painlessly removed by primary care clinicians in office using a ring-forceps polypectomy technique.

Conclusion: Cervical polyps are common and generally do not require intervention if asymptomatic. Patients with cervical polyps should still participate in routine cervical cancer screening. Symptomatic cervical polyps in appropriate patients can be removed by PCPs and sent for histologic examination to avoid long wait times and unnecessary referrals to gynecology.