Üçüncü Basamak Bir Sağlık Kuruluşunda 2006-2015 Yılları Arasındaki Servikal Sitoloji Sonuçlarının Değerlendirilmesi

Öz

Amaç:  Servikal kanser taramasının amacı, servikal kanser ile ilişkili morbidite ve mortaliteyi azaltmaktır. Araştırmamızda hastanemizin elektronik kayıtları retrospektif olarak incelenerek servikal sitolojik anomalilerin sıklığının değerlendirilmesi amaçlanmıştır.

Materyal ve Metot: Hastane elektronik kayıtlarından 2006-2015 yılları arasında 54999 hastanın demografik verisine ve Pap-smear sonuçlarına ulaşılmıştır.

Bulgular: Servikal sitolojik anomalilerin sıklığı %2,27; ASCUS, LSIL, HSIL sıklığı sırasıyla; %1,29; %0,27; % 0,11 olduğu görüldü. Hastalarda HSIL sıklığının en fazla olduğu yaş grubunun 71 yaş ve üzeri grup olduğu görüldü.

Sonuç: Türkiye’deki anormal servikal sitoloji sıklığı Avrupa, israil ve Kuzey Amerika ile benzer bulunmuştur.  Hastanemizin 10 yılı aşkın süredeki servikal sitoloji sonuçları dünyanın birçok ülkesi ile uyumlu olsa da ileri yaş grubunda artmış anormal smear sonuçlarına rastlanmıştır.

Anahtar Kelimeler

• Anormal servikal sitoloji,kanser taraması,Pap- smear,servikal prekanseröz lezyonlar

The Evaluation of Cervical Cytology Results in a Tertiary Health Centre Between 2006-2015

Abstract

Objectives: The main goal of cervical cancer cytologic screening is to prevent mortality and morbidity associated with cervical cancer. We aimed to retrospectively evaluate the prevalence of cervical cytological abnormalities in patient records obtained from electronic data at our tertiary hospital.

Materials and Methods: Demographic characteristics and data on cervical cytological abnormalities were evaluated from patients (n=54999) who underwent Pap tests in our hospital from 2006 to 2015.

Results: Data were collected from 54999 patients. Overall, the prevalence of cervical cytological abnormalities was 2.27%; the prevalence of ASCUS, LSIL, and HSIL was 1.29%, 0.27% and 0.11%, respectively. The highest prevalence of HSIL was seen in the group older than 71 years.

Conclusion: The abnormal cervical cytological prevalence rate in Turkey is similar to Europe, Israel, and North America. The data from our hospital over 10 years are compatible with data from various centres around the world and the country, apart from the increase in the incidence of abnormal smears in older age groups. 

Keywords

• Abnormal cervical cytology,cancer screening,cervical precanserous lesions,Pap smear

References

1. 1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics. CA: a cancer journal for clinicians 2012;65:87-108.
2. 2. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer. J Clin 2012;62:10-29.
3. 3. Tarver T. Cancer Facts & Figures 2012. American Cancer Society (ACS). Journal of Consumer Health on the Internet 2012;16(3):366-7.
4. 4. Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, et al. The ACS-ASCCP-ASCP Cervical Cancer Guideline Committee, American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening guidelines for the prevention and early detection of cervical cancer. CA: A Cancer Journal for Clinicians 2012;62:147-72.
5. 5. Schlichte MJ, Guidry J. Current Cervical Carcinoma Screening Guidelines. J Clin Med 2015;4(5):918-32, doi: 10.3390/jcm4050918.
6. 6. Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J. Liquid compared with conventional cervical cytology: a systematic review andmeta-analysis. Obstet Gynecol 2008;111:167-77.
7. 7. Whitlock EP, Vesco KK, Eder M, Lin JS, Senger CA, Burda BU. Liquid-based cytology and human papillomavirus testing to screen for cervical cancer: asystematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2011;155:687-97.
8. 8. Davey E, Barratt A, Irwig L et al. Effect of study design and quality on unsatisfactory rates, cytologyclassifications, and accuracy in liquid-based versus conventional cervicalcytology: a systematic review. Lancet 2006;367(9505):122-32.

9. 9. Smith JH. Bethesda 2001. Cytopathology 2002;13(1):4-10. 10. Bassal R, Schejter E, Bachar R, Shapira H, Sandbank J, Supino Rosin L. Cervical Pap screening among Israeli women, 2005-2010. Arch Gynecol Obstet 2014;289:615-22.
10. 11. Nokiani FA, Akbari H, Rezaei M, Madani H, Ale Agha ME. Cost--effectiveness of pap smear in Kermanshah, Iran. Asian Pac J Cancer Prev 2008;9:107-10.
11. 12. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol 2012;29:45-7.
12. 13. Altaf FJ, Mufti ST. Pattern of cervical smear abnormalities using the revised Bethesda system in a tertiary care hospital in Western Saudi Arabia. Saudi Med J 2012;33:634-9.
13. 14. Okonda S, Wright C, Michelow P. The status of cervical cytology in Swaziland, Southern Africa: a descriptive study. Cytojournal 2009;6:14.
14. 15. Ayhan A, Dursun P, Kuscu E et al.Turkish Cervical Cancer And Cervical Cytology Research Group. Prevalence of cervical cytological abnormalities in Turkey. Int J Gynaecol Obstet 2009;106:206-9.
15. 16. Mehmetoglu HC, Sadikoglu G, Ozcakir A, Bilgel N. Pap smear screening in the primary health care setting: A study from Turkey. N Am J Med Sci 2010;2:467-72.
16. 17. Brinton LA, Schiffman M. Epidemiology of Gynecologic Cancers. In: Barakat RR, Markman M, Randall M (editors). Principles and Practice of Gynecologic Oncology, 5th edition, Philadelphia: Lippincott Williams & Wilkins; 2009:1-30.
17. 18. Wolfendale MR, King S, Usherwood MM. Abnormal cervical smears: are we in for an epidemic? Br Med J (Clin Res Ed) 1983;287(6391):526-8.
18. 19. Chatchotikawong U, Ruengkhachorn I, Laiwejpithaya S. Factors predicting pathologic significance among women with atypical glandular cells on liquid-based cytology. Int J Gynaecol Obstet 2012;119(1):30-4.
19. 20. Mood NI, Eftekhar Z, Haratian A, Saeedi L, Rahimi-Moghaddam P, Yarandi F. A cytohistologic study of atypical glandular cells detected in cervical smears during cervical screening tests in Iran. Int J Gynecol Cancer 2006;16:257–61.
20. 21. Wright JD, Davila RM, Pinto KR, Merritt DF, Gibb RK et al. Cervical dysplasia in adolescents. Obstet Gynecol 2005;106:115–20.