Histopathological results of hpv dna positivity in patients WHO have been CO-tested as cervical cancer screening test, as a retrospective analysis

Cervical cancer is the fourth most common cancer among women after breast, colon and lung cancer. Almost all of these are caused by HPV infection. This cancer, which is 90% mortal in underdeveloped countries, develops from preinvasive lesions with slow progression. Therefore, the latent phase is a long lasting disease. With the introduction of Pap smear in routine screening, the approval of the HPV test for screening by the FDA, and the addition of colposcopic examinations to the process, cervical cancer has become the only cancer that can be eliminated worldwide. Our aim in this retrospective study is to determine the demographic characteristics of HPV DNA positive patients who applied to our clinic, who underwent Pap smear and HPV DNA test (co-test), to evaluate the histopathological results of cervical cytology, and results of biopsy during colposcopy and clinical management according to the HPV DNA types of the patients. Another aim is to determine the types of HPV DNA in our region, with the results to contribute Turkey statistics, to contribute the screening and diagnosis programmes and also immunization programmes. For this purpose, 429 patients who applied to Gazi University Medical Faculty Gynecology and Obstetrics Clinic between January 2018 and December 2019, had Pap smear and HPV DNA test (co-test) and had positive HPV test were included in our study. When we look at the distribution of HPV types in the data we obtained, it was seen that those with HPV DNA type 16 positive constitute 20.0% of the group, those with HPV DNA type 18 positive with 8.4%, and those with other high risk types of HPV DNA positive with a rate of 61.4%. Colposcopic biopsy results of patients with cytology reported as LSIL were found to be chronic cervicitis at a rate of 56.9% and colposcopic biopsy results of patients with cytology results of HSIL were found to be chronic cervicitis at a rate of 32%. While malignancy was not detected in the LSIL group, 4% adenocarcinoma in situ and 4% squamous cell carcinoma in the HSIL group were detected. When the biopsy results of patients with HPV DNA type 16 positive were evaluated, it was observed that there was adenocarcinoma in situ with a rate of 1.9% and squamous cell carcinoma with a rate of 3,9%, while it was found that patients with HPV DNA type 18 had adenocarcinoma in situ with a rate of 5,4%. However, no patients with squamous cell carcinoma were detected in this group. Similarly, no malignancy was found in the HPV DNA other high risk types positive group. Detection of HPV DNA with low and high oncogenic risk in samples taken from the cervix, combining them with the results of Pap smear and biopsy results obtained during colposcopy are important in predicting the development of cervical cancer or showing pre-cancerous changes and planning the appropriate treatment and follow-up protocol. Our aim to reduce the incidence of cervical cancer are; Reaching the 9-26 age group, immunizing against HPV with vaccine, and then making the 30-65 age group women apply to KETEM for screening tests. Keywords: Cervical cancer, Preinvasive lesion, HPV DNA test, Pap smear test