Evaluation of Cervical Smear Screening and Colposcopy Assessments at a Tertiary Obstetrics and Gynecology Center in the Blacksea Region of Turkey: Retrospective Chart-Review of the Last 5 Years

Abstract

Cervical cancer is the fourth most common cancer worldwide. Furthermore, it is the 9thmost common cancer in all ages and the 4thmost common in the 25-49 age group of women in Turkey. Given these significantly high figures, it is a significant public health problem. Therefore, this study aimed to evaluate the epidemiological characteristics of patients screened for Human papillomavirus (HPV) in a tertiary-care setting in Turkey. This is a retrospective chart review of patients admitted for clinical examinations and who underwent cervical cancer screening between 1 January 2017 and 1 March 2022. The data analyses included HPV positivity, genotype distribution, cytology analyses, colposcopy results, pathological diagnoses, and follow-up methods. A total of 529 cases were included, of whom 41.6% were HPV positive. The most frequent HPV types were HPV-16 (16.6%) and HPV-high risk (HR) (12.1%). Cytology analyses revealed atypical squamous cells of undetermined significance (ASC-US) in 17.8% and low-grade squamous intraepithelial lesions (LSIL) in 12.7%. The most common pathological finding was cervicitis in 23.1% (n=122), cervical intraepithelial neoplasia (CIN)-1 in 9.3% (n=49), CIN-3 in 4% (n=21), and CIN-2 in 3.8% (n=20) of patients. HPV-59 (p=0.027) and HPV-HR (p=0.003) genotypes were determined in higher proportions in patients with ≥ASC-US cytology, and HPV-16 was significantly higher among patients with ≥CIN-1 lesions. The HPV positivity rate was 41.6% among women admitted to our tertiary-care university hospital for gynecological assessments. Distribution differences in HPV genotypes, cytology assessments, and pathological diagnoses might reflect the population characteristics in different geographical regions from previous studies. Our results provide current data for HPV surveillance in the Turkish population.