Cervical Cancer Screening in Turkey: A Community-based Experience After 60 Years of Pap Smear Usage

Abstract

Cervical cancer is the second most common cancer in females in the World with around 500,000 new cases occurring annually, but the first in the developing countries with a high mortality if not diagnosed early. Papanicolau (Pap) smear is a cheap, easy-to-apply and widely accepted test which has been long used to detect cervical cancer at very early stages. However, despite being available for nearly 60 years, the test can hardly be considered to have become successfully applied in many communities. We aimed in this study to present the results of a screening survey for cervical cancer which targeted a women population aged between 35 and 40 living in a semi-rural area in the province of Hatay, located in the eastern Mediterranean region of Turkey, with specific aims of increasing early diagnosis, education and raising population awareness about cancers. This community-based descriptive study covered 512 women between 35 and 40 years of age living at Armutlu with a mean age of 37.6±1.7. Gynecologic examinations revealed cervical erosion in 8 (1.6%), vaginitis in 193 (37.7%) and normal findings in 311 (60.7%); pathological evaluation reports of the smears were negative in 290 (56.6%), inflammation in 218 (42.6%) and ASC-US in 4 (0.8%), according to the 2001 Bethesda classification. It can be concluded that Pap smear test -proven to be a very valuable test at the clinical level-should also be widely used at the community level to detect cervical cancer at very early stages to reduce both the mortality and morbidity among healthy people. The need for continuous community-based cervical cancer screening programs is strongly suggested.

Women's Perceptions and Attitudes about Cervical Cancer in Turkey: Kato's Device as an Alternative to the Pap Smear

“…In the studies conducted in Turkey, this rate was reported as 20.0% by Kalyoncu et al (2003); 51.3% by Akyuz et al (2006); 16.2% by Karaca (2008); 28.9% by Gurel et al (2009);19.4% by Ak et al (2010); 11.8% by (Erbil et al, 2011); 9.4%by Demirhindi et al (2012), and 16.6% by Karabulutlu (2013). It was determined in our research that 70 out of the 246 women (28.5%) included in the study had taken a Pap smear test before, while 176 of the women (71.5%) had never taken the test.…”

Knowledge, Attitudes and Behaviors of Women Over 20 Years Old on Cervix Cancer in Istanbul, Turkey

“…While studies conducted in developed countries, pap smear screening rates over 70% (Gonzalez et al, 2012;Shekhar et al, 2013;Suh et al, 2013), in developing countries, this ratio was below 70% (Imam et al, 2008;Gan and Dahlui, 2013;Wongwatcharanukul et al, 2014). In Turkey studies, ratios ranged between 9.4%-68.5% (Uysal and Birsel, 2009;Erbil et al, 2011;Demirhindi et al, 2012;Bekar et al, 2013;Coskun et al, 2013;Demirtas and Acikgoz, 2013;Dinc, 2013;Karabulutlu, 2013;Karadag et al, 2014;Sahin et al, 2014). Results of our study in Turkey are similar to the work done in developing countries.…”

Zeynep Kamil Kadın Doğum Ve Çocuk Hastanesindeki 50,645 servikal smear sonucunun değerlendirilmesi.

“…Serviks kanseri halen kadınlarda 2. en sık görülen kanserdir ve 2002 de dünya çapında 239,000 kadının ölümüne neden olmuştur (6). Servikal lezyonların premalign aşamada tespit ve tedavi edilmesi hastalığa yakalanma ve hastalıktan ölüm oranlarını düşürür.…”

“…Tayvan'dan yapılan bir çalışmada 1995-2006 yılları arasında Papsmear ile servikal kanser tarama programı uygulanarak kanser oranı %47.8 azaltılmıştır (9). Gelişmiş ülkelerde serviks kanserinin daha az görülmesinin nedeni Pap smear metodunun 50 yıldır etkin bir şekil-de kullanılmasıyla açıklanmıştır (1,5,6). Pap smear yapılma oranları Pakistanda %2.6, Gü-ney Afrikada %27, Amerika Birleşik Devletlerinde %93'tür (5).…”

“…Etkin ve yaygın bir şekilde kullanı-mının, serviks kanseri riskini %35-80 oranında azalttığı düşünülmektedir (5). Tarama programları gelişmiş ülkelerde yaygın ve sistematik olarak kullanılırken, ülkemizde birkaç pilot bölge dışında tam olarak uygulanamamaktadır (6,7). Gerçekçi tarama programlarının oluşturulabil-mesi için ülkemizdeki gerçek yaygınlığını ve popülasyonlara göre dağılımını, artış veya azalış eğilimini bilmek önemlidir.…”