Bursa ili 2017-2022 Yılları Arası HPV Tarama Sonuçlarının Değerlendirilmesi

Amaç: Bu çalışmada ilimizde servikal kanser için taranan yaklaşık 120bin kadının HPV genotiplendirmesi ve sitolojik bulguların incelenmesiyle riskli tipler yerel düzeyde tespit edilmeye çalışılacaktır. Yöntem: Ülkemizde birinci basamak sağlık kuruluşlarında toplumsal tabanlı kanser tarama programı kapsamında kadın kanserleri arasında önemli bir yere sahip olan serviks kanserinin taranması amacıyla 30 ile 65 yaş aralığındaki kadınlara HPV ve Papsmear testi uygulanarak her 5 yılda bir tekrarlanmaktadır. HPV Testi ve Pap-Smear Testi kişiden aynı anda alınmaktadır. Çalışmada Bursa geneli birinci basamak sağlık kuruluşları ve Kanser Erken Teşhis ve Tarama Eğitim Merkezlerinde (KETEM) serviks kanseri taraması amacıyla Ocak 2017- Ağustos 2022 arasında alınmış 118865 smear testi Halk Sağlığı Yönetim Sistemleri (HSYS) veri tabanı kullanılarak değerlendirilmiştir. Bulgular: Bursa il genelinde birinci basamak serviks kanseri taraması amacıyla 30-65 yaş aralığındaki kadınlardan alınmış 118865 papsmear değerlendirilmiştir. Çalışmadaki kadınların yaş ortalaması 46.19±9.06 olup, alınan numunelerde HPV prevalansı %5.6 olarak hesaplanmıştır. Papsmear sonucunda aynı kişide birden fazla HPV tipi pozitif olarak bulunabilmekte olup çalışmada en sık tespit edilen tip HPV16 (%25.6) olarak bulunmuştur. 30-44 yaş grubunda anormal sitolojik bulguları olanların oranı %56.8; 45-54 yaş grubunda %27.5 iken bu oran 55-65 yaş grubunda %15.7 olup istatistiksel olarak tüm gruplar arası fark anlamlıdır Sonuç: Kadınlar için önemli bir halk sağlığı sorunu olan serviks kanserinin erken teşhisi için HPV taraması alt gruplarının analizi, yüksek riskli türlerde biyopsi yapılması ülkemizde ve dünya genelinde artan şekilde devam etmektedir. Ülkemizin birçok ilinden ve dünya genelinden bildirilen HPV türlerindeki farklı sıklıklarına rağmen kansere yol açtığı bilinen HPV 16 ve 18 en sık görülen etken olması HPV aşısının önemini bir kat daha artırmaktadır. Her bölgenin kendi prevalans çalışmasını yapması en sık görülen servikal sitoloji, yaş grubu ve HPV etkenlerini belirlemesi riskli popülasyonlarda alınacak tedbirlerin belirlenmesinde ilk aşamayı oluşturmalıdır.

Anahtar Kelimeler:

pap smear, yaş grubu, servikal sitoloji, human papillomavirüs, displazi, HPV tarama programı

Evaluation of HPV Screening Results Between 2017-2022 in Bursa Province

Objective: In this study, it will be tried to determine the risk types at the local level by HPV genotyping and cytological findings of approximately 120 thousand women screened for cervical cancer in our province. Methods: Within the scope of the community-based cancer screening program in primary health care institutions in our country, the HPV and Papsmear test is applied to women between the ages of 30 and 65 and repeated every 5 years in order to screen for cervical cancer, which has an important place among female cancers. HPV Test and Pap-Smear Test are taken from the person at the same time. In the study, 118865 smear tests taken between January 2017 and August 2022 for cervical cancer screening in primary health care institutions and Cancer Early Diagnosis and Screening Training Centers (KETEM) in Bursa were evaluated using the Public Health Management Systems (HSYS) database. Results: 118,865 pap smears taken from women between the ages of 30-65 were evaluated for primary care cervical cancer screening across the province of Bursa. The mean age of the women in the study was 46.19±9.06, and the prevalence of HPV was calculated as 5.6% in the samples taken. As a result of Papsmear, more than one HPV type can be found positive in the same person, and the most common type detected in the study was HPV16 (25.6%). The rate of those with abnormal cytological findings in the 30-44 age group was 56.8%; While it is 27.5% in the 45-54 age group, this rate is 15.7% in the 55-65 age group, and the difference between all groups is statistically significant. Conclusion: Analysis of HPV screening subgroups and biopsies in high-risk species for the early diagnosis of cervical cancer, which is an important public health problem for women, continue increasingly in our country and around the world. The fact that HPV 16 and 18, which are known to cause cancer, are the most common agents, despite the different frequencies in HPV types reported from many provinces of our country and around the world, increases the importance of HPV vaccine even more. Each region should conduct its own prevalence study, determine the most common cervical cytology, age group and HPV factors, and should constitute the first step in determining the precautions to be taken in risky populations.

Keywords:

pap smear, cervical cytology, human papillomavirus, age group, dysplasia, HPV screening program,

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