Cervical Cytological Screening Results of 8,495 Cases in Turkey - Common Inflammation but Infrequent Epithelial Cell Abnormalities?

Daloglu, Ferah Tuncel; Karakaya, Yeliz Arman; Balta, Hilal; Altun, Eren; Duman, Aslıhan

doi:10.7314/apjcp.2014.15.13.5127

Cited by 6 publications

(11 citation statements)

References 25 publications

(15 reference statements)

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“…Turkey implemented a population based cervical screening program using the Pap smear in 2004. However, organized population screening achieved annual coverage rates of only 1–2%, much too low to be effective, although there was also a substantial amount of opportunistic screening . The main logistical reasons for this situation were lack of coordinating infrastructure, quality assurance and insufficient laboratory cytopathology capability …”

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confidence: 99%

“…However, organized population screening achieved annual coverage rates of only 1-2%, much too low to be effective, although there was also a substantial amount of opportunistic screening. [10][11][12][13][14][15] The main logistical reasons for this situation were lack of coordinating infrastructure, quality assurance and insufficient laboratory cytopathology capability. [11][12][13][14][15][16][17] Some of these limitations can be minimized by moving to HPV testing as standalone primary screening, since the test can be automated and interpretation is objective, thus not requiring subjective and tedious reading of thousands of cytology slides by cytopathologists with some percent of additional pathology verification.…”

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confidence: 99%

“…[10][11][12][13][14][15] The main logistical reasons for this situation were lack of coordinating infrastructure, quality assurance and insufficient laboratory cytopathology capability. [11][12][13][14][15][16][17] Some of these limitations can be minimized by moving to HPV testing as standalone primary screening, since the test can be automated and interpretation is objective, thus not requiring subjective and tedious reading of thousands of cytology slides by cytopathologists with some percent of additional pathology verification. [18][19][20] In 2014, Turkey redesigned the screening program including a revamped local call and recall strategy and a centralized and fully automatized monitoring of individual screening status, with HPV tests as the primary screening tool, well defined national algorithms-including extended screening intervals and referral protocols, a single nationwide centralized diagnostics laboratory, and a sustainable agreement with the diagnostics industry.…”

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confidence: 99%

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Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women

Gültekin

Karaca²,

Küçükyıldız³

et al. 2017

Intl Journal of Cancer

105

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To evaluate the Turkey's nationwide HPV DNA screening program on the basis of first 1 million screened women. Women over age 30 were invited for population based screening via HPV DNA and conventional cytology. Samples were collected by family physicians and the evaluations and reports had been performed in the National Central HPV laboratories. The acceptance rate for HPV based cervical cancer screening after first invitation was nearly 36.5%. Since HPV DNA tests have been implemented, cervical cancer screening rates have shown 4–5‐fold increase in primary level. Through the evaluation of all, HPV positivity was seen in 3.5%. The commonest HPV genotypes were 16, followed by 51, 31, 52 and 18. Among the 37.515 HPV positive cases, cytological abnormality rate was 19.1%. Among HPV positive cases, 16.962 cases had HPV 16 or 18 or other oncogenic HPV types with abnormal cytology (>ASC‐US). These patients were referred to colposcopy. The colposcopy referral rate was 1.6%. Among these, final clinico‐pathological data of 3.499 patients were normal in 1.985 patients, CIN1 in 708, CIN2 in 285, CIN3 in 436 and cancer in 85 patients and only pap‐smear program could miss 45.9% of ≥CIN3 cases. The results of 1 million women including the evaluation of 13 HPV genotypes with respect to prevalence, geographic distribution and abnormal cytology results shows that HPV DNA can be used in primary level settings to have a high coverage rated screening program and is very effective compared to conventional pap‐smear.

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confidence: 99%

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confidence: 99%

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Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women

Gültekin

Karaca²,

Küçükyıldız³

et al. 2017

Intl Journal of Cancer

105

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“…Infection rates are quite variable in the cervicovaginal smear case studies in the literature. Infection rates vary between 1.9% (Erdem et al) and 31.54% (Patel et al) [2,6,7,14,15] . Our infection rate was 16.91%, and this was the second highest rate in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…The highest prevalence of Candidiasis in the literature was reported in Perez et al 's study in Colombia (9.1%). Candidiasis rates varied between 1% (Erdem et al) and 9.1% [2,6,7,14,15] . Our Candidiasis rate was 2.15% and was lower compared to the foreign literature, but was consistent with the Turkish literature.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Distribution of Cervicovaginal Smear in Bursa and Its Surrounding

Erkinüresin¹

2019

Haydarpasa Numune Med J

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Introduction: In this study, our aim was to analyze Pap smear cervical cancer screening results at our hospital. We also sought to compare our ASC/SIL rate with the relevant studies in the literature, which is one of the quality standard criteria for the pathology laboratory. Methods: In our study, digital reports of 6902 cases diagnosed according to the Bethesda Reporting System for Pap cervical cancer screening and other medical indications in the pathology department of our hospital between 1st January 2018 and 31st December 2018 were reviewed retrospectively. Results: When 6902 cervicovaginal smear cases were analyzed concerning epithelial abnormality, 6528 cases (94.6%) were reported as NILM, and seven cases (0.1%) were reported as an inadequate smear. Epithelial abnormality was detected in the remaining 367 (5.3%) cases. Out of 367 cases,279 (4.0%) of them were reported as ASC-US;42 cases (0.6%) as AGC-NOS;24 cases (0.3%) as LSIL;12 cases (0.2%) as ASC-H, seven cases (0.1%) as HSIL; one case (0.0%) as LSIL and AGC-NOS; one case (0.0%) as ASC-H and AGC-NOS and one case (0.0%) as squamous cell carcinoma (SCC). The ASC/SIL rate of our laboratory for the year 2018 was 9.125. Discussion and Conclusion: Our SCC rate was 0.02%, which was the second-lowest rate in the relevant literature. The reason for this may be the success of the cervicovaginal Pap smear screening program performed in our region. Our inadequate cervicovaginal smear rate concerning assessment was the lowest rate in the literature. Our ASC/SIL rate was 9.125, and this was the third highest ASC/SIL rate in the literature. The reason for our laboratory's 2018 ASC/SIL rate of 9.125 may be the concern of some of our pathologists of false-negative reports. We detected various differences between epithelial abnormality and infection prevalence in the cervicovaginal smears in our region and epithelial abnormality and infection prevalence in different regions of the world. Intra-departmental case presentations and in-service training could be organized to keep the ASC/SIL rate in the pathology laboratory under three. At the same time, pathologists' quarterly ASC/SIL rates could be calculated and reported to the pathologists.

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Severe cervical inflammation and high-grade squamous intraepithelial lesions: a cross-sectional study

Long

Chen

et al. 2020

Arch Gynecol Obstet

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Cervical Cytological Screening Results of 8,495 Cases in Turkey - Common Inflammation but Infrequent Epithelial Cell Abnormalities?

Cited by 6 publications

References 25 publications

Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women

Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women

Diagnostic Distribution of Cervicovaginal Smear in Bursa and Its Surrounding

Severe cervical inflammation and high-grade squamous intraepithelial lesions: a cross-sectional study

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