New Screening Method For Cervical Cancer- Polar Probe

Objective: Although extensive screening methods had been developed, cervical cancer remains to be an essential health problem. Early detection and administration of appropriate therapy is still a lifesaving procedure, especially for cervical cancer. The most common screening method for cervical cancer is still the cervical cytology (Pap-test). We aim to find out the advantages and disadvantages of a recently developed method, which is called as Polar Probe. Methods: Two different approaches had been used (conventional Pap test and Polar Probe), and 1438 patients were included in the study. Of these, 819 had been screened with Polar Probe. All eligible patients were firstly screened using Polar Probe and then using the Pap test. Each patient with an abnormal Polar Probe result was referred to colposcopy room, where she was re-evaluated using colposcopy. Results: The rate of abnormal smear result was 1.04%, and the corresponding percentage was calculated as 0.62% in LSIL, 0.34% in ASCUS, and 0.069% in HSIL. A total of 819 patients underwent Polar Probe, and the results were abnormal in 261 patients and normal in 558 patients. Abnormality rate was 1% in Pap test and 31.9% in Polar Probe. Although the positive predictive value was 27% for Polar Probe test and 16% for Pap test, as the colposcopy was indicated only for the patients with abnormal results in Polar Probe. The need for colposcopy dramatically increased with the use of Polar Probe. Conclusion: Use of Polar Probe alone was not found to be cost effective. Combination with other methods of screening would decrease the cost of the process.

Servikal Kanser İçin Yeni Tarama Metodu- Polar Probe

Amaç: Kapsamlı tarama yöntemleri geliştirilmiş olmasına rağmen, rahim ağzı kanseri temel bir sağlık sorunu olmaya devam etmektedir. Uygun tedavinin erken tespiti ve uygulanması, özellikle serviks kanseri için hala hayat kurtarıcı bir prosedürdür. Serviks kanseri için en yaygın tarama yöntemi servikal sitolojidir (Pap-testi). Bu çalışmada Polar Probe adı verilen ve yeni geliştirilen bir tarama yöntemin etkinliğini test ettik. Yöntemler: İki farklı yaklaşım kullanıldı (geleneksel Pap testi ve Polar Probe) ve çalışmaya 1438 hasta dahil edildi. Bu hastalardan 819 tanesi Polar Probe ile de tarandı. Tüm uygun hastalar önce Polar Probe ve ardından Pap testi kullanılarak tarandı. Anormal bir Polar Probe sonucu olan her hasta kolposkopi odasına yönlendirildi ve burada kolposkopi cihazı kullanılarak hastalar yeniden değerlendirildi. Bulgular: Anormal smear sonucunun oranı %1,04 idi ve ilgili yüzde LSIL'de %0,62, ASCUS'ta %0,34 ve HSIL'de %0,069 olarak hesaplandı. Toplam 819 hastaya Polar Probe uygulandı ve sonuçlar 261 hastada anormal ve 558 hastada normaldi. Anormallik oranı Pap testinde %1 ve Polar Probe %31,9 idi. Pozitif prediktif değer Polar Probe testi için %27 ve Pap testi için %16’idi. Kolposkopi sadece Polar Probe'da anormal sonuçları olan hastalarında yapıldı. Bu çalışmada Polar Probe kullanımıyla kolposkopi ihtiyacı önemli ölçüde artmıştır. Sonuç: Sadece Polar Probe kullanımını kolposkopi gerekliliği nedeniyle maliyeti artırmaktadır. Diğer tarama yöntemleri ile kombinasyon, işlemin maliyetini düşürebilir.

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1. Cancer, I.A.f.R.o., Globocan 2018: estimated cancer incidence, mortality and prevalence worldwide in 2018 http://gco.iarc.fr/today/explore

2. Mirili C., Yılmaz A., Bilici M., Tekin S.B. Long-Term Follow-Up Outcomes of Cervical Cancer Patients: A Single Center Experience from the East Anatolian Region of Turkey Dicle Med J 2019; 46 : 857–65.

3. Corneanu L M, S tanculescu D , C orneanu C . H PV a nd cervical squamous intraepithelial lesions: clinicopathological study. Rom J Morphol Embryol. 2011; 52: 89-94.

4. Long S, L ei W, F eng Y , L v D , C ai Y , Yang P . The feasibilities of TruScreen for primary cervical cancer screening: a self-controlled study. Arch Gynecol Obstet. 2013; 288: 113-8.

5. American College of O, Gynecologists. ACOG Practice Bulletin No. 99: management of abnormal cervical cytology and histology. Obstet Gynecol. 2008; 112: 1419- 44.

6. Gibb R K, M artens M G. The i mpact o f l iquid-based cytology in decreasing the incidence of cervical cancer. Rev Obstet Gynecol. 2011; 4: S2-S11.

7. Singer A, Coppleson M, Canfell K et all. A real time optoelectronic device as an adjunct to the Pap smear for cervical screening: a multicenter evaluation. Int J Gynecol Cancer. 2003; 13 :804-11.

8. Mould T A J, Q.S.C., Lovegrove J, Gallivan S, Singer A, The acceptability of cytological screening for cervical cancer compared to a new electronic screening device—the Polarprobe. Proceedings of the EUROGIN Third International Congress, 1997. European Research Organization on Genital Infection and Neoplasia, 1997 (March 24-27).

9. Coppleson M, Reid BL, Skladnev VN, Dalrymple JC. An electronic approach to the detection of pre-cancer and cancer of the uterine cervix: a preliminary evaluation of Polarprobe. Int J Gynecol Cancer. 1994; 4: 79-83.

10. Singer, A., Clinical experience with the usage of the Polarprobe. Proceedings of the EUROGIN Third International Congress, 1997. European Research Organization on Genital Infection and Neoplasia, 1997( 1997 ): p. March 24-27.

11. Abdul S , B rown B H, M ilnes P , T idy JA. T he u se of electrical impedance spectroscopy in the detection of cervical intraepithelial neoplasia. Int J Gynecol Cancer. 2006; 16: 1823-32.

12. Pruski D, Kedzia W, Przybylski M, et all. Assesment of real optoelectronic method in the detection of cervical intraepithelial neoplasia. Ginekol Pol. 2008; 79: 342-6.

13. He X K, L uo X P, M ao L Z, e t a ll. A n optoelectronic cervical cancer screening system for screening cervical cancer: comparison with cervical cytology. Nan Fang Yi Ke Da Xue Xue Bao. 2010; 30: 2304-6.

14. Turkish Cervical C, Cervical Cytology Research G. Prevalence of cervical cytological abnormalities in Turkey. Int J Gynaecol Obstet. 2009; 106: 206-9.

15. Davey DD, Woodhouse S, Styer P, Stastny J, Mody D. Atypical epithelial cells and specimen adequacy: current laboratory practices of participants in the college of American pathologists interlaboratory comparison program in cervicovaginal cytology. Arch Pathol Lab Med. 2000; 124: 203-11.