Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2014, Vol 30, Num, 1     (Pages: 011-017)

Abnormal Cervical Cytology Risk Factors in the Western Black Sea Region and the Importance of Health Insurance

Serap SİMAVLI 1,2, İkbal KAYGUSUZ 3, Selma ÇUKUR 4, Ferda AKSEL 4

1 Department of Obstetric and Gynecology, Pamukkale University, Faculty of Medicine, DENİZLİ, TURKEY
2 Laboratory of Reproductif Endocrinology, Brigham and Women's Hospital , Harvard Medical School, Boston, MA, USA
3 Turgut Özal University, Faculty of Medicine, ANKARA, TURKEY
4 Department of Pathology, Bolu İzzet Baysal State Hospital, BOLU, TURKEY

DOI: 10.5146/tjpath.2013.01193
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Objective: To evaluate the prevalence of abnormal cervical cytological findings in the Western Black Sea Region and investigate an association between socio-demographic risk factors and the presence of cytological abnormalities.

Material and Method: The reports of 11,539 cervical smears diagnosed according to Bethesda System 2001 version in the Pathology Department between January 2011 and December 2012 were reviewed retrospectively from the hospital records and cytopathology reports. Repeated smear results, unsatisfactory smear results, patients with known gynecologic malignancy history, smear results of patients with hysterectomy and smear results of patients whose socio-demographic information could not be obtained were excluded from the evaluation. The results of 7,740 patients who met the criteria for the study were evaluated.

Results: The prevalence of cervical cytological abnormalities was 1.8 % in general. The prevalence rates for atypical squamous cells with undetermined significance (ASC-US), atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and atypical glandular cells (AGC) were 1.16%, 0.11%, 0.29%, 0.15%, and 0.03% respectively. The prevalence of cytologically diagnosed cervical invasive neoplasia was 0.025%. Advanced age, low education level (primary school or less) and not having health insurance were found as to be risk factors for preinvasive and invasive lesions. Women who had a high school education and previously had a smear test had decreased risk for developing preinvasive and invasive lesions.

Conclusion: This study shows prevalence of abnormal cervical cytology findings and associoted risk factors in the Western Black Sea Region of Turkey. The most important risk factor was identified as not having health insurance.

Keywords : Vaginal smears, Uterine cervical neoplasms, Risk factors, Health insurance, Turkey