HPV based screening had begun to be recommended for most of the countries in the world, based on the recent scientific evidence (1-3). It had been implemented to the Turkish cervical cancer screening program in 2014. Turkish data is now the largest prospective series on primary HPV screening in the world. The program is organised and all ladies over 30 years of age are screened for 13 High Risk HPV types via HC2. The ones with positive results are further analyzed after DNA extraction for HPV genotypes (Genomica) for epidemiological purposes together with reflex cytology evaluations. All analysis is done in a central MEGA HPV laboratory implemented in Ankara.
The program is organised and all ladies over 30 years of age are screened for 13 High Risk HPV types via HC2. The ones with positive results are further analyzed after DNA extraction for HPV genotypes (Genomica) for epidemiological purposes together with reflex cytology evaluations. All analysis is done in a central MEGA HPV laboratory implemented in Ankara. Daily, >5,000 samples are analyzed and the results are reported within 10 days of collecting the sample. A specialized population based software is used to evaluate and monitor all steps from sample collection and transport to reporting results, showing the progress through each step of this 10 day process. Untill now, almost 1.2 million ladies have been screened with HPV DNA testing and no samples have been lost or mixed up
A total amount of 1.152.242 ladies had been screened by the end of Januarry 2016 since August 2014. Nearly 100.000 ladies are being screened monthly and by the mid of the year it will be over 1.5 million. The overall HPV positivity rate is 3.58%. The most common genotypes were 16 (27,6%) and 18 (7,75%).The cytoanomaly rate is around 20% among HPV positive cases. The most common anomalies detected were LGSIL (11,9%), ASC-US (6,09%), HGSIL(0,78%), ASC-H (0,21%) and AGC(0,45%)
HPV Prevelance was found to be very low in Turkey which makes this test a good screening method for us. HPV screening has incread-sed number of people attending to the screening program.The software also gives a national HPV Map, with genotypes across the whole country for epidemiological monitoring. This is a unique and a first nationally organised and implemented HPV based screening program in the world.
1. Huh WK, et. al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Gynecol Oncol 2015 Feb;136(2):178-82.
2. Comprehensive cervical cancer control: a guide to essential practice – 2nd ed. World Health Organization publications. 2014, Geneva.
3. Arbyn M, et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Am J Obstet Gynecol. 2013 Mar;208(3):184.e1-184.e11.