Türk Kadınlarında Rahim Ağzı Kanserinin Erken Tanısına Yönelik Tutumlar ve İlişkili Faktörler: Kesitsel Bir Çalışma
Yıl 2024,
Sayı: 9, 30 - 37, 30.08.2024
Hülya Gürler
,
Seval Cambaz Ulaş
Öz
Giriş: Bu çalışma Türk kadınlarında serviks kanserinin erken tanısına yönelik tutumları ve ilişkili faktörleri belirlemek amacıyla yapılmıştır.
Yöntem: Bu çalışma kesitsel tipte bir çalışmadır. Araştırma, Manisa ili Aile Sağlığı Merkezi'nde 30-65 yaş arası halen veya eskiden cinsel yönden aktif olan kadınlar (n=339) ile yürütülmüştür. Araştırmada sosyodemografik form ve rahim ağzı kanseri erken tanı tutum ölçeği kullanıldı. İstatistiksel analizler SPSS 22.0 versiyonu kullanılarak yapıldı. Analizde tanımlayıcı istatistikler ve Students t testleri kullanıldı.
Bulgular: Çalışma grubundaki kadınların yaş ortalaması 38.7±6.52 idi. Rahim ağzı kanseri erken tanı tutum ölçeği toplam puan ortalaması 99.38±7.11 ile orta düzeyde bulundu. Kadınların %64.3’ünün pap-smear testi yaptırdığı görüldü. Düzenli jinekolojik muayene yaptırmanın ve ailesinde rahim ağzı kanseri olan kişilerin bulunmasının kadınların rahim ağzı kanserinin erken tanısına yönelik tutumlarını etkilediği görüldü.
Sonuç: Çalışma grubundaki kadınların serviks kanseri erken tanıya yönelik tutum ölçeğinden aldıkları puan ortalamasının orta düzeyde olduğu belirlendi. Düzenli jinekolojik muayene yaptırmanın kadınların rahim ağzı kanseri erken tanı tutumlarını etkilediği belirlendi.
Etik Beyan
Çalışma için Manisa Celal Bayar Üniversitesi Tıp Fakültesi Etik Kurulu'ndan onay alınmıştır.
(Tarih: 18.04.2018, REF: 20.478.486) ve bilgilendirilmiş onam formu katılımcılardan temin edilmiştir. Araştırmacı, çalışmanın amacını ve gerekçesini açıklayarak katılımcıların
çalışmanın niteliğini anladıklarından emin olmuştur. Tüm katılımcılar bilgilendirilmiş onam formunu imzalamışlardır.
*Bu makale “Servikal Kanser Erken Teşhis Tutumları ve Jinekolojik Muayene
Kentsel Alanlarda Yaşayan Kadınların Algıları” başlıklı, Manisa Celal
Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Yüksek Lisans Tezi'nden türetilmiştir.
Teşekkür
Araştırmamıza katılan ve destek veren tüm kadınlara teşekkür ederiz.
Kaynakça
- Adams, S. A., Haynes, V. E., Brandt, H. M., Choi, S. K., Young, V., and Eberth, J. M. (2020). Cervical cancer screening behaviors and proximity to federally qualified health centers in South Carolina. Cancer Epidemiology, 32, 1–7. https://doi.org/10.1016/j.apnr.2017.10.006
- Akbas, M., Gokyıldız, S. S., and Avcıbay, V. B. (2020). Identification of women’s attitudes towards early diagnosis of cervical cancer. TJFMPC, 14(4), 605-612. https://doi.org/10.21763/tjfmpc.766646
- Aksu, S., and Turgut, B. (2020). Anxiety level of women before gynecological examination and effective factors. Journal of Vacotional School of Health Services, 8, 688–700. https://doi.org/10.33715/inonusaglik.762143
- Asgarlou, Z., Tehrani, S., Asghari, E., Arzanlou, M., Naghavi-Behzad, M., and Reza, P. (2016). Cervical cancer prevention knowledge and attitudes among female university students and hospital staff in Iran. Asian Pac J Cancer Prev, 17(11), 4921-4927. https://doi.org/10.22034/APJCP.2016.17.11.4921
- Ashtarian, H., Mirzabeigi, E., Mahmoodi, E., and Khezeli. M. (2017). Knowledge about cervical cancer and pap smear and the factors influencing the pap test screening among women. IJCBNM, 5(2), 188-195.
- Aweke, YH., Ayanto, SY., and Ersado, TL. (2017). Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study. PLoS ONE, 12(7), e0181415. https://doi.org/10.1371/journal.pone.0181415
- Bekar, M., Guler, H., Evcili, F., Demirel, G., and Duran, Ö. (2013). Determining the knowledge of women and their attitudes regarding gynecological cancer prevention. Asian Pacific Journal of Cancer Prevention, 14, 6055-6059. https://doi.org/10.7314/apjcp.2013.14.10.6055
- Büyükkayacı, DN., Yüksel, KD., Albayrak, SA., Topuz, Ş., and Yılmazel, G. (2015). Knowledge and practices breast and cervical cancer screening among womens over age of 40. JAREN, 1(1), 30-38.
- Cappiello, J., and Levi, A. (2016). The annual gynecologic examination updated for the 21st century. Nursing for Women’s Health, 20(3), 315–9. https://doi.org/10.1016/j.nwh.2016.03.006
- Castle, P. E., and Fetterman, B. (2009). Five-year experience of human papillomavirus DNA and papanicolaou test cotesting. Obstet Gynecol, 113(3), 595-600. https://doi.org/10.1097/aog.0b013e3181996ffa
- Cimke, V. S., and Borekci, G. (2019). The determination of the knowledge level and behavior of Turkish women from various occupations about human papillomavirus, cervical cancer, and pap smear test. J Can Res Ther, 15, 1235-44. https://doi.org/10.4103/jcrt.jcrt_1195_16
- Coronado, I. E., Anakwenze, C., Aung, M., and Jolly, P. (2016). Increasing cervical cancer awareness and screening in Jamaica: Effectiveness of theory-based educational intervention. Int. J Envıron Res Publıc Health, 13(53), 1-11. https://dx.doi.org/10.3390%2Fijerph13010053
- Daşıkan, Z., and Sevil, Ü. (2017). Psychosocial factors restraining gynecological examinations in women. STED, 26(2), 75-83.
- Open Epi: open-source epidemiologic Statistics for public health. (2020, july 21). www.OpenEpi.com
- Dehdari, T., Hassani, L., Shojaeizadeh, D., Hajizadeh, E., Nedjat, S., and Abedini, M. (2016). Predictors of Iranian women's intention to first papanicolaou test practice: An application of protection motivation theory. Indian J Cancer, 53, 50-3. https://doi.org/10.4103/0019-509x.180857
- Demiray, A., Korhan, E. A., Çevik, K., Khorshid, L., and Yücebilgin, M. S. (2014). A comparison of the state anxiety related to gynecological examination in patients attended in public and private institution. Electronic Journal of Vocational Colleges, 4(4), 122-129.
- Deniz, S., Coşkun, F., Öztaş, D., and Kurt, A. Ö. (2018). Knowledge, attitudes and behaviors of breast and cervical cancers and screenings of women working in primary health care services. JBUON, 23 (Suppl 1), 44-52.
- Duran, TE. (2011). Examination with the health belief model of women attitudes to cervical cancer and early diagnosis in Turkey: A qualitative study. Asian Pacific Journal of Cancer Prevention, 12, 1179-1184.
- Ekechi, C., Olaitan, A., Ellis, R., Koris, J., Amajuoyi, A., and Marlow, L. A. (2015). Knowledge of cervical cancer and attendance at cervical cancer screening: A survey of black women in London. BMC Public Health, 14, 1096. https://doi.org/10.1186/1471-2458-14-1096
- Enerly, E., Bonde, J., Sche, K., Pedersen, H., Lönnberg, S., and Nygard, M. (2016). Self-sampling for human papillomavirus testing among non-attenders increases attendance to the Norwegian cervical cancer screening programme. PLoS ONE, 1(4), 1-14. https://doi.org/10.1371/journal.pone.0151978
- Gökgöz N., and Aktaş D. (2015). Determination of women awareness level of cervical cancer & conducting pap-smear test. Yıldırım Beyazıt University Journal of Nursing, 3(2), 11-23.
- Gümüş BA., and Çam O. (2011). Relationships between early diagnosis attitudes in cervical cancer of women and levels of self-esteem, body perception and hopelessness. Nobel Medicus, 7(3), 46-52.
- Jia, Y., Li, S., Yang, R., Zhou, R., Xiang, Q., and Hu, T. (2013). Knowledge about cervical cancer and barriers of screening program among women in Wufeng country, a high-incidence region of cervical cancer in China. PLoS ONE, 8, 1-7. https://doi.org/10.1371/journal.pone.0067005
- Kızılırmak, A., and Kocaöz, S. (2018). The factors influencing health beliefs about cervical cancer and pap smear test among the women at a university. STED, 27(3), 165–75.
- Mosavel, M. (2011). Health promotion and cervical cancer in South Africa: Why adolescent daughters can teach their mothers about early detection. Health Promot Int, 27, 157-66. https://doi.org/10.1093/heapro/dar014
- Önal, B., and Yılmaz, A. F. (2020). Attitudes of women toward for early diagnosis of cervical cancer: health responsibility and associated factors. Cukurova Medical Journal, 45(1), 14-21.
- Özcan, H., Dağlı, A., and Koçak, D. Y. (2020). Experiences of women with gynecological examination: The example of Gümüşhane. Health Care Academical Jounal, 7, 188–195.
- Özmen, D., and Özsoy, S. A. (2009). Attitude scale towards early diagnosis of cervical cancer with health belief model approach. Journal of Ege University Nursing Faculty, 25, 51-69.
- Öztürk, Y., and Gürsoy, E. (2020). Obstacles preventing women from having pap smear screening test. STED, 29(1), 61-68.
- Papapetrou, I., Charalambous, G., Sissouras, A., and Jelastopulu, E. (2016). Cervical cancer screening in the municipality of nicosia, Cyprus–coverage and association with socioeconomic determinants. Austin J Public Health Epidemiol, 3(1), 1-6.
- Richard, A., Rohrmann, S., Schmid, SM., Tirri, B.F., Huang, D.J., Güth, U. et al. (2015). Lifestyle and health-related predictors of cervical cancer screening attendance in a Swiss population-based study. Cancer Epidemiol, 39, 870-6. https://doi.org/10.1016/j.canep.2015.09.009
- Risasi, A., Mulumba, P., Verdonck, K., Broeck, VD., and Praet, M. (2014). Knowledge, attitude and practice about cancer of the uterine cervix among women living in Kinshasa, the Democratic Republic of Congo. BMC Women's Health, 14(30), 1-13. https://dx.doi.org/10.1186%2F1472-6874-14-30
- Saleh, N., Abu-Gariba, M., Yehoshua, I., and Peleg, R. (2018). Barriers to implementation of a pelvic examination among family doctors in primary care clinics. Postgraduate Medicine, 130(3), 341–7.
https://doi.org/10.1080/00325481.2018.1438078
- Sönmez, Y., Nayir, T., Köse, S., Gökçe, B., and Kişioğlu, A. N. (2012). Evaluation of the health beliefs of women towards early diagnosis of breast and cervical cancer. Journal of Hacettepe University Faculty of Nursing, 19(4), 124-30.
- Sudenga, S. L., Rositch, A. F., Otieno, W. A., and Smith, J. S. (2013). Brief report: knowledge, attitudes, practices and perceived risk of cervical cancer among Kenyan women. Int J Gynecol Cancer, 23(5), 895–9.
https://doi.org/10.1097/IGC.0b013e31828e425c
- Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., and Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 71, 209–49. https://doi.org/10.3322/caac.21660
- Taşkın, L. (2016). Obstetrics and Women's Health Nursing Book (9. Baskı). Sistem Ofset Printing Press.
- Thapa, N., Maharjan, M., Petrini, A. M., Shah, R., Shah, S., Maharjan, N. et al. (2018). Knowledge, attitude, practice and barriers of cervical cancer screening among women living in mid-western rural. Nepal J Gynecol Oncol, 29(4), e57. https://doi.org/10.3802/jgo.2018.29.e57
- The Ministry of Health of Türkiye, National Standards for Cervical Cancer Screening Program. (2018, Jul 27). https://hsgm.saglik.gov.tr/tr/kanser-tarama-standartlari/listesi/483-serviks-kanseri-tarama-program%C4%B1-ulusalstandartlar%C4%B1.html.
- The Ministry of Health of Türkiye. Health Statistic Yearbook 2019. (2020, Sep 20). https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/health-statistics-yearbook-2019pdf.pdf
- The Ministry of Health of Türkiye. Health Statistic Yearbook 2020. (2022, July 20). https://sbsgm.saglik.gov.tr/Eklenti/43400/0/siy2020-eng-26052022pdf.pdf
Attitudes toward Early Diagnosis of Cervical Cancer and Associated Factors in Turkish Women: A Cross-Sectional Study
Yıl 2024,
Sayı: 9, 30 - 37, 30.08.2024
Hülya Gürler
,
Seval Cambaz Ulaş
Öz
Introduction: The aim of this study was to determine attitudes toward early diagnosis of cervical cancer and associated factors in Turkish women.
Methods: This study is a cross-sectional type. The study conducted with women in Family Health Center in Manisa, the province of Türkiye, aged 30 – 65 who are still and/or were sexually active (n=339). Sociodemographic form and the cervical cancer early diagnosis attitude scale were used in the study. Statistical analyses were performed using SPSS, version 22.0. In the analysis, descriptive statistics and Student t tests were used.
Results: The mean age of the women in the study group was 38.7±6.52. The mean total score of the cervical cancer early diagnosis attitude scale was found to be 99.38±7.11 at a moderate level. It was seen that 64.3% of women had a pap-smear test. It was observed that having regular gynecological examinations and having persons with cervical cancer in their families affects the attitudes of women towards early diagnosis of cervical cancer.
Conclusion: The average score of the cervical cancer early diagnosis attitude scale of the women in the study group was found to be moderate. It has been determined that having regular gynecological examinations affects women’s cervical cancer early diagnosis attitudes.
Etik Beyan
The study approval was obtained from
Manisa Celal Bayar University Medical Faculty Ethics Committee
(Date: 18.04.2018, REF: 20.478.486) and the informed consent
form was obtained from the participants. The researcher explained the study’s purpose and rationale to make sure that participants
understood the nature of the study. All participants signed the
consent form.
*This article is derived from the master's thesis titled “Cervical
Cancer Early Diagnosis Attitudes and Gynaecological Examination
Perceptions of Women Living in Urban Areas” in Manisa Celal
Bayar University Institute of Health Sciences.
Teşekkür
We would like to thank all the women who
participated and supported our research.
Kaynakça
- Adams, S. A., Haynes, V. E., Brandt, H. M., Choi, S. K., Young, V., and Eberth, J. M. (2020). Cervical cancer screening behaviors and proximity to federally qualified health centers in South Carolina. Cancer Epidemiology, 32, 1–7. https://doi.org/10.1016/j.apnr.2017.10.006
- Akbas, M., Gokyıldız, S. S., and Avcıbay, V. B. (2020). Identification of women’s attitudes towards early diagnosis of cervical cancer. TJFMPC, 14(4), 605-612. https://doi.org/10.21763/tjfmpc.766646
- Aksu, S., and Turgut, B. (2020). Anxiety level of women before gynecological examination and effective factors. Journal of Vacotional School of Health Services, 8, 688–700. https://doi.org/10.33715/inonusaglik.762143
- Asgarlou, Z., Tehrani, S., Asghari, E., Arzanlou, M., Naghavi-Behzad, M., and Reza, P. (2016). Cervical cancer prevention knowledge and attitudes among female university students and hospital staff in Iran. Asian Pac J Cancer Prev, 17(11), 4921-4927. https://doi.org/10.22034/APJCP.2016.17.11.4921
- Ashtarian, H., Mirzabeigi, E., Mahmoodi, E., and Khezeli. M. (2017). Knowledge about cervical cancer and pap smear and the factors influencing the pap test screening among women. IJCBNM, 5(2), 188-195.
- Aweke, YH., Ayanto, SY., and Ersado, TL. (2017). Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study. PLoS ONE, 12(7), e0181415. https://doi.org/10.1371/journal.pone.0181415
- Bekar, M., Guler, H., Evcili, F., Demirel, G., and Duran, Ö. (2013). Determining the knowledge of women and their attitudes regarding gynecological cancer prevention. Asian Pacific Journal of Cancer Prevention, 14, 6055-6059. https://doi.org/10.7314/apjcp.2013.14.10.6055
- Büyükkayacı, DN., Yüksel, KD., Albayrak, SA., Topuz, Ş., and Yılmazel, G. (2015). Knowledge and practices breast and cervical cancer screening among womens over age of 40. JAREN, 1(1), 30-38.
- Cappiello, J., and Levi, A. (2016). The annual gynecologic examination updated for the 21st century. Nursing for Women’s Health, 20(3), 315–9. https://doi.org/10.1016/j.nwh.2016.03.006
- Castle, P. E., and Fetterman, B. (2009). Five-year experience of human papillomavirus DNA and papanicolaou test cotesting. Obstet Gynecol, 113(3), 595-600. https://doi.org/10.1097/aog.0b013e3181996ffa
- Cimke, V. S., and Borekci, G. (2019). The determination of the knowledge level and behavior of Turkish women from various occupations about human papillomavirus, cervical cancer, and pap smear test. J Can Res Ther, 15, 1235-44. https://doi.org/10.4103/jcrt.jcrt_1195_16
- Coronado, I. E., Anakwenze, C., Aung, M., and Jolly, P. (2016). Increasing cervical cancer awareness and screening in Jamaica: Effectiveness of theory-based educational intervention. Int. J Envıron Res Publıc Health, 13(53), 1-11. https://dx.doi.org/10.3390%2Fijerph13010053
- Daşıkan, Z., and Sevil, Ü. (2017). Psychosocial factors restraining gynecological examinations in women. STED, 26(2), 75-83.
- Open Epi: open-source epidemiologic Statistics for public health. (2020, july 21). www.OpenEpi.com
- Dehdari, T., Hassani, L., Shojaeizadeh, D., Hajizadeh, E., Nedjat, S., and Abedini, M. (2016). Predictors of Iranian women's intention to first papanicolaou test practice: An application of protection motivation theory. Indian J Cancer, 53, 50-3. https://doi.org/10.4103/0019-509x.180857
- Demiray, A., Korhan, E. A., Çevik, K., Khorshid, L., and Yücebilgin, M. S. (2014). A comparison of the state anxiety related to gynecological examination in patients attended in public and private institution. Electronic Journal of Vocational Colleges, 4(4), 122-129.
- Deniz, S., Coşkun, F., Öztaş, D., and Kurt, A. Ö. (2018). Knowledge, attitudes and behaviors of breast and cervical cancers and screenings of women working in primary health care services. JBUON, 23 (Suppl 1), 44-52.
- Duran, TE. (2011). Examination with the health belief model of women attitudes to cervical cancer and early diagnosis in Turkey: A qualitative study. Asian Pacific Journal of Cancer Prevention, 12, 1179-1184.
- Ekechi, C., Olaitan, A., Ellis, R., Koris, J., Amajuoyi, A., and Marlow, L. A. (2015). Knowledge of cervical cancer and attendance at cervical cancer screening: A survey of black women in London. BMC Public Health, 14, 1096. https://doi.org/10.1186/1471-2458-14-1096
- Enerly, E., Bonde, J., Sche, K., Pedersen, H., Lönnberg, S., and Nygard, M. (2016). Self-sampling for human papillomavirus testing among non-attenders increases attendance to the Norwegian cervical cancer screening programme. PLoS ONE, 1(4), 1-14. https://doi.org/10.1371/journal.pone.0151978
- Gökgöz N., and Aktaş D. (2015). Determination of women awareness level of cervical cancer & conducting pap-smear test. Yıldırım Beyazıt University Journal of Nursing, 3(2), 11-23.
- Gümüş BA., and Çam O. (2011). Relationships between early diagnosis attitudes in cervical cancer of women and levels of self-esteem, body perception and hopelessness. Nobel Medicus, 7(3), 46-52.
- Jia, Y., Li, S., Yang, R., Zhou, R., Xiang, Q., and Hu, T. (2013). Knowledge about cervical cancer and barriers of screening program among women in Wufeng country, a high-incidence region of cervical cancer in China. PLoS ONE, 8, 1-7. https://doi.org/10.1371/journal.pone.0067005
- Kızılırmak, A., and Kocaöz, S. (2018). The factors influencing health beliefs about cervical cancer and pap smear test among the women at a university. STED, 27(3), 165–75.
- Mosavel, M. (2011). Health promotion and cervical cancer in South Africa: Why adolescent daughters can teach their mothers about early detection. Health Promot Int, 27, 157-66. https://doi.org/10.1093/heapro/dar014
- Önal, B., and Yılmaz, A. F. (2020). Attitudes of women toward for early diagnosis of cervical cancer: health responsibility and associated factors. Cukurova Medical Journal, 45(1), 14-21.
- Özcan, H., Dağlı, A., and Koçak, D. Y. (2020). Experiences of women with gynecological examination: The example of Gümüşhane. Health Care Academical Jounal, 7, 188–195.
- Özmen, D., and Özsoy, S. A. (2009). Attitude scale towards early diagnosis of cervical cancer with health belief model approach. Journal of Ege University Nursing Faculty, 25, 51-69.
- Öztürk, Y., and Gürsoy, E. (2020). Obstacles preventing women from having pap smear screening test. STED, 29(1), 61-68.
- Papapetrou, I., Charalambous, G., Sissouras, A., and Jelastopulu, E. (2016). Cervical cancer screening in the municipality of nicosia, Cyprus–coverage and association with socioeconomic determinants. Austin J Public Health Epidemiol, 3(1), 1-6.
- Richard, A., Rohrmann, S., Schmid, SM., Tirri, B.F., Huang, D.J., Güth, U. et al. (2015). Lifestyle and health-related predictors of cervical cancer screening attendance in a Swiss population-based study. Cancer Epidemiol, 39, 870-6. https://doi.org/10.1016/j.canep.2015.09.009
- Risasi, A., Mulumba, P., Verdonck, K., Broeck, VD., and Praet, M. (2014). Knowledge, attitude and practice about cancer of the uterine cervix among women living in Kinshasa, the Democratic Republic of Congo. BMC Women's Health, 14(30), 1-13. https://dx.doi.org/10.1186%2F1472-6874-14-30
- Saleh, N., Abu-Gariba, M., Yehoshua, I., and Peleg, R. (2018). Barriers to implementation of a pelvic examination among family doctors in primary care clinics. Postgraduate Medicine, 130(3), 341–7.
https://doi.org/10.1080/00325481.2018.1438078
- Sönmez, Y., Nayir, T., Köse, S., Gökçe, B., and Kişioğlu, A. N. (2012). Evaluation of the health beliefs of women towards early diagnosis of breast and cervical cancer. Journal of Hacettepe University Faculty of Nursing, 19(4), 124-30.
- Sudenga, S. L., Rositch, A. F., Otieno, W. A., and Smith, J. S. (2013). Brief report: knowledge, attitudes, practices and perceived risk of cervical cancer among Kenyan women. Int J Gynecol Cancer, 23(5), 895–9.
https://doi.org/10.1097/IGC.0b013e31828e425c
- Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., and Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 71, 209–49. https://doi.org/10.3322/caac.21660
- Taşkın, L. (2016). Obstetrics and Women's Health Nursing Book (9. Baskı). Sistem Ofset Printing Press.
- Thapa, N., Maharjan, M., Petrini, A. M., Shah, R., Shah, S., Maharjan, N. et al. (2018). Knowledge, attitude, practice and barriers of cervical cancer screening among women living in mid-western rural. Nepal J Gynecol Oncol, 29(4), e57. https://doi.org/10.3802/jgo.2018.29.e57
- The Ministry of Health of Türkiye, National Standards for Cervical Cancer Screening Program. (2018, Jul 27). https://hsgm.saglik.gov.tr/tr/kanser-tarama-standartlari/listesi/483-serviks-kanseri-tarama-program%C4%B1-ulusalstandartlar%C4%B1.html.
- The Ministry of Health of Türkiye. Health Statistic Yearbook 2019. (2020, Sep 20). https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/health-statistics-yearbook-2019pdf.pdf
- The Ministry of Health of Türkiye. Health Statistic Yearbook 2020. (2022, July 20). https://sbsgm.saglik.gov.tr/Eklenti/43400/0/siy2020-eng-26052022pdf.pdf