Buccoliero AM et al. (1) should be credited for their study on liquid-based endometrial cytology in the management of a subpopulation of asymptomatic postmenopausal women. Their conclusion that liquidbased endometrial cytology may reduce unnecessary, more invasive, and expensive procedures is striking. However, they have obtained a specificity of 94% for endometrial cytology after categorizing the cases studied as nonpathologic and pathologic. If we were to categorize them as malignant and nonmalignant cytology, the resultant sensitivity would only be 83%. Cytohistologic correlation had been possible only in 94 cases (29%) of the study population, a fact that demands concern on the two techniques. Two hundred twenty-two biopsies (69%) were inadequate, a figure which is surprisingly high when compared to other similar studies (2) . It may be related to the prevalence of nonneoplastic or hyperplasic cases or due to the sequence of endometrial sampling: first the cytology and then the biopsy as hypothesized by the authors. A brief note on the time gap between endometrial cytology and biopsy is appreciated. We observed the possibility of bias of the investigators who were keen to highlight the efficacy of endometrial cytology in comparison to biopsy.This exercise adds some valuable information to the excising body of knowledge on managing asymptomatic postmenopausal women with liquid-based endometrial cytology. Low cost, good tolerability, and the fact that it can be carried out as an outpatient procedure (3) makes it an excellent option for women with other comorbid factors. It opens the door for future trends and advances in this method such as immunohistochemical staining rather than routine Papanicolaou stain of the cytology obtained. Gynecologists should be made aware of the advantages of liquid-based endometrial cytology in assessing the endometrium.

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