Background:The aim of this study was to compare specimen adequacy of SAP-I provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology,and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.Methods:Endometrial specimens from women (n =1514) with risk factors were obtained using an SAP-l device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy.Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou.Histological samples were processed in routine pathology and stained by hematoxylin and eosin.Results:Adequate specimens for cytology were obtained from 1458/1541 patients (96.3％),while adequate samples for pathology were obtained from 285/375 patients (76％).However,for postmenopausaI women,1006 of 1045 cytology (86.3％) were adequate,153 of 238 histology (64.3％) were adequate,it was easier to collect cytological specimens than histological specimens (P ＜ 0.05).The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4％ (sensitivity,73％; specificity,95.8％; positive predictive value,75％; and negative predictive value,95.3％).Conclusions:Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.