Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2017, Vol 33, Num, 2     (Pages: 134-143)

What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts

İlknur Çetinaslan TÜRKMEN 1, Alp USUBÜTÜN 2, Aslı ÇAKIR 1, Özlem AYDIN 3, Filiz Aka BOLAT 4, Metin AKBULUT 5, Serdar ALTINAY 6, Sema ARICI 7, Figen ASLAN 8, Müzeyyen ASTARCI 9, Emine Kılıç BAĞIR 10, Yılmaz BAŞ 11, Nuray BAŞSÜLLÜ 12, Betül ÇELİK 13, Handan ÇETİNER 14, Bengü ÇOBANOĞLU 15, Abdullah AYDIN 15, Hale DEMİR 16, Hayriye Tatlı DOĞAN 17, Kamile Gülçin EKEN 18, Selma Şengiz ERHAN 19, Gülgün ERDOĞAN 20, Kıvılcım Eren ERDOĞAN 21, Funda EREN 22, Şafak ERSÖZ 23, Pınar FIRAT 24, İclal GÜRSES 25, Nihan HABERAL 26, Dudu Solakoğlu KAHRAMAN 27, Gülçin Harman KAMALI 19, Yasemin Yuyucu KARABULUT 28, Mehmet KEFELİ 29, Meral KOYUNCUOĞLU 30, R. Doğan KÖSEOĞLU 31, Bahar MÜEZZİNOĞLU 32, Binnur ONAL 33, Sevgen ÖNDER 2, Zuhal ÖZCAN 34, Elife KIMILOĞLU 34, Hatice ÖZER 35, F. Cavide SÖNMEZ 7, Sevinç ŞAHİN 36, Nurhan ŞAHİN 37, Tülin YALTA 38

1 Department of Pathology, Istanbul Medipol University Faculty of Medicine, İstanbul
2 Hacettepe University Faculty of Medicine, Ankara
3 Acibadem University Faculty of Medicine, İstanbul
4 Başkent University ERH, ADANA
5 Pamukkale University Faculty of Medicine, DENİZLİ
6 Bagcilar ERH, Istanbul
7 Bezmialem Vakif University Faculty of Medicine, Istanbul
8 Dumlupinar University Evliya Celebi ERH, KÜTAHYA
9 Abant Izzet Baysal University Faculty of Medicine, BOLU
10 Cukurova University Faculty of Medicine, ADANA
11 Hitit University Çorum ERH, ÇORUM
12 Bilim University Faculty of Medicine, Istanbul
13 Antalya ERH, ANTALYA
14 Zeynep Kamil ERH, İSTANBUL
15 Medeniyet University Goztepe ERH, İSTANBUL
16 Istanbul University Cerrahpaşa Medical Faculty, İSTANBUL
17 Yildirim Beyazit University Ankara Ataturk ERH, ANKARA
18 Sisli Hamidiye Etfal ERH, İSTANBUL
19 Okmeydani ERH, İSTANBUL
20 Akdeniz University Faculty of Medicine, ANTALYA
21 Mersin State Hospital, MERSİN
22 Marmara University Faculty of Medicine, İSTANBUL
23 Karadeniz Technical University Faculty of Medicine, TRABZON
24 Istanbul University Faculty of Medicine, İSTANBUL
25 Mersin University Faculty of Medicine, MERSİN
26 Baskent University Faculty of Medicine, ANKARA
27 Tepecik ERH, İZMİR
28 Cankiri State Hospital, ÇANKIRI
29 Ondokuz Mayis University Faculty of Medicine, SAMSUN
30 Dokuz Eylul University Faculty of Medicine, İZMİR
31 Gaziosmanpasa University Faculty of Medicine, TOKAT
32 Kocaeli University Faculty of Medicine, KOCAELİ
33 Diskapi ERH, ANKARA
34 Taksim ERH, İSTANBUL
35 Cumhuriyet University Faculty of Medicine, SİVAS
36 Bozok University Faculty of Medicine, YOZGAT
37 Inonu University Faculty of Medicine, MALATYA
38 Trakya University Faculty of Medicine, EDİRNE, TURKEY

DOI: 10.5146/tjpath.2016.01380
Viewed: 3863
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Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories.

Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire.

Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers.

Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

Keywords : Cervical Smear, Epithelial cell abnormality, Turkey