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Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi

Year 2022, , 152 - 163, 01.04.2022
https://doi.org/10.20518/tjph.999736

Abstract

Amaç: Bütün dünyada uygulanan ulusal HPV tarama programları prekanseröz lezyonların oluşumundan önce persistan HPV enfeksiyonunun tespit edilmesini sağlayarak serviks kanserinin önlenmesinde en güvenilir, etkili ve maliyet etkinliği yüksek yöntemdir. Bu çalışmanın amacı Niğde’de COVID-19 pandemisi kaynaklı kısıtlamaların HPV tarama programı üzerindeki etkilerini nesnel ölçütler kullanarak araştırmaktır. Ayrıca ilimizde ulusal tarama hedeflerinin gerçekleştirilme oranları, ilçeler bazında tarama oranlarının istatistiğinin çıkarılması, yıllık tarama oranları, HPV prevelansı ve HPV genotiplerinin dağılımını incelemek de hedeflenmektedir.
Yöntem: Tanımlayıcı tipte tasarlanan bu çalışma için Niğde ili ve ilçelerinde Ocak 2017 - Haziran 2021 tarihleri arasında HPV taraması için serviks sürüntüsü aldıran kadınların elektronik medikal kayıtları retrospektif olarak incelenmiştir.
Bulgular: Toplam 11430 servikal sürüntünün 629 (5,51%) tanesi pozitif, 10765 tanesi (94,18%) negatif olarak rapor edilmiştir. En sık %17 ile HPV16’dır. İlimizde çalışma süresinde primer HPV taramaları ile hedef nüfusun ancak %15,66’sına ulaşılabilmiştir. COVİD-19 pandemisi nedeniyle 2020 yılında önceki yıllara göre anlamlı olarak daha az tarama yapılmıştır (p=0,001). Ayrıca HPV taramasında gözlenen mevsimsel ritim pandemi ile birlikte kaybolmuştur.
Sonuç: COVID-19 pandemisi nedeniyle uygulanan kısıtlamalar yaşamın her alanında olduğu gibi tarama programları üzerinde de oldukça olumsuz etkiler yaratmıştır. İlimizde yapılan taramalarda HPV pozitiflik oranının ülkemiz ortalamasının üstünde olduğu halde tarama oranlarının bölge ortalamasının altında kalması acil bir eylem planını elzem kılmaktadır. Özellikle tarama programlarının eylül-mayıs ayları arasında yoğunlaştırılması uygun bir strateji olarak görülmektedir. Ayrıca ülkemiz genelinde her il için tarama programlarının ilçeler bazında ve aylar bazında eğilimleri incelenerek bireyselleştirilmiş tarama programlarının oluşturulması tarama programlarının performansını arttırıcı etki sağlayacaktır.

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References

  • 1. Wu EQ, Liu B, Cui JF, et al. Prevalence of type-specific human papillomavirus and pap results in Chinese women: A multi-center, population-based cross-sectional study. Cancer Causes Control. 2013;24(4):795-803.
  • 2. Kadioǧlu BG, Tanriverdi Ȩsra Çinar, Alay H, Uçar M. Relation of cervical cancer with the results of human papillomavirus (HPV) screening carried out via hybrid capture 2 Method on 52.000 Women in Erzurum. Mikrobiyol Bul. 2018;52(4):367-375.
  • 3. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-E386.
  • 4. Kan Ö, Görkem Ü, Bariş A, Koçak Ö, Toğrul C, Yildirim E. Evaluation of the frequency of human papillomavirus (HPV) in women admitted to cancer early diagnosis and screening training centers (KETEM) and analysis of HPV genotypes. Turk Hij ve Deney Biyol Derg. 2019;76(2):163-168.
  • 5. Ayhan A, Eraydın E. Human Papillomavirus (HPV) Tiplerinin Prevalansının Saptanması. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Derg. Published online 2020:0-2.
  • 6. Demir E, Ceyhan M, Simsek M, et al. The prevalence of different HPV types in Turkish women with a normal Pap smear. J Med Virol. 2012;84(8):1242-1247.
  • 7. Türkiye Kanser İstatistikleri, Kanser Daire Başkanlığı.; 2015.
  • 8. Muñoz N, Xavier Bosch F, Castellsagué X, et al. Against which human papillomavirus types shall we vaccinate and screen? The international perspective. Int J Cancer. 2004;111(2):278-285.
  • 9. Chin’Ombe N, Sebata NL, Ruhanya V, Matarira HT. Human papillomavirus genotypes in cervical cancer and vaccination challenges in Zimbabwe. Infect Agent Cancer. 2014;9(1).
  • 10. Psyrri A, DiMaio D. Human papillomavirus in cervical and head-and-neck cancer. Nat Clin Pract Oncol. 2008;5(1):24-31.
  • 11. Köse FM, Naki MM. Cervical premalignant lesions and their management. J Turkish Ger Gynecol Assoc. 2014;15(2):109-121.
  • 12. von Elm E m. fl. Checklist of items that should be included in reports of cross-sectional studies. Int J Public Health. 2008;53:3-4.
  • 13. Kaji AH, Schriger D, Green S. Looking through the retrospectoscope: Reducing bias in emergency medicine chart review studies. Ann Emerg Med. Published online 2014.
  • 14. Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG. Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses 2018, Vol 10, Page 729. 2018;10(12):729.
  • 15. Wright TC, Stoler MH, Behrens CM, Sharma A, Zhang G, Wright TL. Primary cervical cancer screening with human papillomavirus: End of study results from the ATHENA study using HPV as the first-line screening test. Gynecol Oncol. 2015;136(2):189-197.
  • 16. Mayrand M-H, Duarte-Franco E, Rodrigues I, et al. Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer. N Engl J Med. 2009;357(16):1579-1588.
  • 17. Ronco G, Giorgi-Rossi P, Carozzi F, et al. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol. 2010;11(3):249-257.
  • 18. Bulkmans NWJ, Rozendaal L, Snijders PJF, et al. POBASCAM, a population-based randomized controlled trial for implementation of high-risk HPV testing in cervical screening: Design, methods and baseline data of 44,102 women. Int J Cancer. 2004;110(1):94-101.
  • 19. Bhatla N, Singhal S. Primary HPV screening for cervical cancer. Best Pract Res Clin Obstet Gynaecol. 2020;65:98-108.
  • 20. Gultekin M, Dundar S, Keskinkilic B, et al. How to triage HPV positive cases: Results of four million females. Gynecol Oncol. 2020;158(1):105-111.
  • 21. World Health Organization. Accelerating the Elimination of Cervical Cancer as a Global Public Health Problem.; 2019.
  • 22. Hall M, Simms K, Lew J, et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. Lancet Public Heal. 2019;4(1):e19-e27.
  • 23. Özkan S, Keskinkılıç B, Gültekin M, et al. ULUSAL KANSER KONTROL PLANI 2013-2018.; 2018.
  • 24. Koruk İ, Gözükara F, Yiğitbay E, Zehra A. Şanlıurfa ’ da birinci basamak sağlık hizmetleri çalışanlarının Ulusal Kanser Tarama Standartları ile ilgili bilgi düzeyi Levels of knowledge of primary healthcare providers in Şanlıurfa about the National. 2015;13(2):127-136.
  • 25. Skroumpelos A, Agorastos T, Constantinidis T, Chatzistamatiou K, Kyriopoulos J. Economic evaluation of HPV DNA test as primary screening method for cervical cancer: A health policy discussion in Greece. PLoS One. 2019;14(12):e0226335.
  • 26. Meijer CJLM, Berkhof J, Castle PE, et al. Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Int J Cancer. 2009;124(3):516-520.
  • 27. Tota JE, Bentley J, Blake J, et al. Approaches for triaging women who test positive for human papillomavirus in cervical cancer screening. Prev Med (Baltim). 2017;98:15-20.
  • 28. Tunçez İH, Aksoy N, Koç M. Ulusal Kanser Tarama Programı Sonuçları; Bir İl Örneği. Phoenix Med J. 2021;3(2):69-73.
  • 29. Hrushesky WJM, Sothern RB, Rietveld WJ, Quiton J Du, Boon ME. Season, Sun, Sex, and Cervical Cancer. Cancer Epidemiol Prev Biomarkers. 2005;14(8):1940-1947.
  • 30. Rietveld W, Boon M, Meulman J. Seasonal fluctuations in the cervical smear detection rates for (pre)malignant changes and for infections. Diagn Cytopathol. 1997;17(6):452-455.
  • 31. Hrushesky WJM, Sothern RB, Rietveld WJ, Du-Quiton J, Boon ME. Sun exposure, sexual behavior and uterine cervical human papilloma virus. Int J Biometeorol 2005 503. 2005;50(3):167-173.

The Seasonal and Demographic Trends of National HPV Screening Program in City of Niğde: The Effects of COVID 19 Pandemic

Year 2022, , 152 - 163, 01.04.2022
https://doi.org/10.20518/tjph.999736

Abstract

Objective: Worldwide applied national HPV screening programmes are the most efficient, reliable and cost-effective method in prevention of cervical cancer by detecting persistent HPV infection before the formation of precancerous lesions. The aim of this study is to investigate the effects of COVID-19 pandemic on HPV screening program in Niğde. Additionally, the HPV screening rates, screening statistics based on districts, yearly screening rates, HPV prevelance and the distribution of HPV genotypes are targeted.
Methods: This is a descriptive study. The medical records of women who underwent HPV screening between January 2017 – June 2021 were retrospectively evaluated.
Results: The 629 (%5,51) of the 11430 cervical swab samples were positive and 10765 (94,18%) were negative for HPV. The most frequent type was HPV 16 with a rate of 17%. Only 15,66% of the target population was screened during the study period. The screening rate was significantly lower in 2020 due to COVID-19 pandemic (p=0,001). Additionally, the seasonal rhythm demolished by the pandemic.
Conclusion: Restrictions due to COVID-19 pandemic negatively affected screening programs as in every aspect of social life. The results reveal that although HPV positivity rate is higher, the screening rates are far below than the geographical regional mean for city of Niğde. This forces the need of an immediate action plan. Especially, condensation of screening between September and May seems like an appropriate strategy. Finally, constituting individualized city plans after investigating and evaluating district-based and monthly screening rates for each city would help to increase the performance of screening programs.

References

  • 1. Wu EQ, Liu B, Cui JF, et al. Prevalence of type-specific human papillomavirus and pap results in Chinese women: A multi-center, population-based cross-sectional study. Cancer Causes Control. 2013;24(4):795-803.
  • 2. Kadioǧlu BG, Tanriverdi Ȩsra Çinar, Alay H, Uçar M. Relation of cervical cancer with the results of human papillomavirus (HPV) screening carried out via hybrid capture 2 Method on 52.000 Women in Erzurum. Mikrobiyol Bul. 2018;52(4):367-375.
  • 3. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-E386.
  • 4. Kan Ö, Görkem Ü, Bariş A, Koçak Ö, Toğrul C, Yildirim E. Evaluation of the frequency of human papillomavirus (HPV) in women admitted to cancer early diagnosis and screening training centers (KETEM) and analysis of HPV genotypes. Turk Hij ve Deney Biyol Derg. 2019;76(2):163-168.
  • 5. Ayhan A, Eraydın E. Human Papillomavirus (HPV) Tiplerinin Prevalansının Saptanması. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Derg. Published online 2020:0-2.
  • 6. Demir E, Ceyhan M, Simsek M, et al. The prevalence of different HPV types in Turkish women with a normal Pap smear. J Med Virol. 2012;84(8):1242-1247.
  • 7. Türkiye Kanser İstatistikleri, Kanser Daire Başkanlığı.; 2015.
  • 8. Muñoz N, Xavier Bosch F, Castellsagué X, et al. Against which human papillomavirus types shall we vaccinate and screen? The international perspective. Int J Cancer. 2004;111(2):278-285.
  • 9. Chin’Ombe N, Sebata NL, Ruhanya V, Matarira HT. Human papillomavirus genotypes in cervical cancer and vaccination challenges in Zimbabwe. Infect Agent Cancer. 2014;9(1).
  • 10. Psyrri A, DiMaio D. Human papillomavirus in cervical and head-and-neck cancer. Nat Clin Pract Oncol. 2008;5(1):24-31.
  • 11. Köse FM, Naki MM. Cervical premalignant lesions and their management. J Turkish Ger Gynecol Assoc. 2014;15(2):109-121.
  • 12. von Elm E m. fl. Checklist of items that should be included in reports of cross-sectional studies. Int J Public Health. 2008;53:3-4.
  • 13. Kaji AH, Schriger D, Green S. Looking through the retrospectoscope: Reducing bias in emergency medicine chart review studies. Ann Emerg Med. Published online 2014.
  • 14. Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG. Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses 2018, Vol 10, Page 729. 2018;10(12):729.
  • 15. Wright TC, Stoler MH, Behrens CM, Sharma A, Zhang G, Wright TL. Primary cervical cancer screening with human papillomavirus: End of study results from the ATHENA study using HPV as the first-line screening test. Gynecol Oncol. 2015;136(2):189-197.
  • 16. Mayrand M-H, Duarte-Franco E, Rodrigues I, et al. Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer. N Engl J Med. 2009;357(16):1579-1588.
  • 17. Ronco G, Giorgi-Rossi P, Carozzi F, et al. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol. 2010;11(3):249-257.
  • 18. Bulkmans NWJ, Rozendaal L, Snijders PJF, et al. POBASCAM, a population-based randomized controlled trial for implementation of high-risk HPV testing in cervical screening: Design, methods and baseline data of 44,102 women. Int J Cancer. 2004;110(1):94-101.
  • 19. Bhatla N, Singhal S. Primary HPV screening for cervical cancer. Best Pract Res Clin Obstet Gynaecol. 2020;65:98-108.
  • 20. Gultekin M, Dundar S, Keskinkilic B, et al. How to triage HPV positive cases: Results of four million females. Gynecol Oncol. 2020;158(1):105-111.
  • 21. World Health Organization. Accelerating the Elimination of Cervical Cancer as a Global Public Health Problem.; 2019.
  • 22. Hall M, Simms K, Lew J, et al. The projected timeframe until cervical cancer elimination in Australia: a modelling study. Lancet Public Heal. 2019;4(1):e19-e27.
  • 23. Özkan S, Keskinkılıç B, Gültekin M, et al. ULUSAL KANSER KONTROL PLANI 2013-2018.; 2018.
  • 24. Koruk İ, Gözükara F, Yiğitbay E, Zehra A. Şanlıurfa ’ da birinci basamak sağlık hizmetleri çalışanlarının Ulusal Kanser Tarama Standartları ile ilgili bilgi düzeyi Levels of knowledge of primary healthcare providers in Şanlıurfa about the National. 2015;13(2):127-136.
  • 25. Skroumpelos A, Agorastos T, Constantinidis T, Chatzistamatiou K, Kyriopoulos J. Economic evaluation of HPV DNA test as primary screening method for cervical cancer: A health policy discussion in Greece. PLoS One. 2019;14(12):e0226335.
  • 26. Meijer CJLM, Berkhof J, Castle PE, et al. Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Int J Cancer. 2009;124(3):516-520.
  • 27. Tota JE, Bentley J, Blake J, et al. Approaches for triaging women who test positive for human papillomavirus in cervical cancer screening. Prev Med (Baltim). 2017;98:15-20.
  • 28. Tunçez İH, Aksoy N, Koç M. Ulusal Kanser Tarama Programı Sonuçları; Bir İl Örneği. Phoenix Med J. 2021;3(2):69-73.
  • 29. Hrushesky WJM, Sothern RB, Rietveld WJ, Quiton J Du, Boon ME. Season, Sun, Sex, and Cervical Cancer. Cancer Epidemiol Prev Biomarkers. 2005;14(8):1940-1947.
  • 30. Rietveld W, Boon M, Meulman J. Seasonal fluctuations in the cervical smear detection rates for (pre)malignant changes and for infections. Diagn Cytopathol. 1997;17(6):452-455.
  • 31. Hrushesky WJM, Sothern RB, Rietveld WJ, Du-Quiton J, Boon ME. Sun exposure, sexual behavior and uterine cervical human papilloma virus. Int J Biometeorol 2005 503. 2005;50(3):167-173.
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Pınar Erdoğan 0000-0002-8435-795X

Fulya Akkaya This is me 0000-0002-7221-891X

Publication Date April 1, 2022
Submission Date September 24, 2021
Acceptance Date December 29, 2021
Published in Issue Year 2022

Cite

APA Erdoğan, P., & Akkaya, F. (2022). Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi. Turkish Journal of Public Health, 20(1), 152-163. https://doi.org/10.20518/tjph.999736
AMA Erdoğan P, Akkaya F. Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi. TJPH. April 2022;20(1):152-163. doi:10.20518/tjph.999736
Chicago Erdoğan, Pınar, and Fulya Akkaya. “Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik Ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi”. Turkish Journal of Public Health 20, no. 1 (April 2022): 152-63. https://doi.org/10.20518/tjph.999736.
EndNote Erdoğan P, Akkaya F (April 1, 2022) Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi. Turkish Journal of Public Health 20 1 152–163.
IEEE P. Erdoğan and F. Akkaya, “Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi”, TJPH, vol. 20, no. 1, pp. 152–163, 2022, doi: 10.20518/tjph.999736.
ISNAD Erdoğan, Pınar - Akkaya, Fulya. “Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik Ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi”. Turkish Journal of Public Health 20/1 (April 2022), 152-163. https://doi.org/10.20518/tjph.999736.
JAMA Erdoğan P, Akkaya F. Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi. TJPH. 2022;20:152–163.
MLA Erdoğan, Pınar and Fulya Akkaya. “Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik Ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi”. Turkish Journal of Public Health, vol. 20, no. 1, 2022, pp. 152-63, doi:10.20518/tjph.999736.
Vancouver Erdoğan P, Akkaya F. Ulusal Primer HPV Tarama Programının Niğde İlinde Mevsimsellik ve Demografik Eğilimleri: COVID-19 Pandemisinin Etkisi. TJPH. 2022;20(1):152-63.

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