Akgün Aktaş Betül, Toptaş Tayfun, Üreyen Işın, Doğan Selen, Uysal Aysel
University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Obstetrics and Gynecology, Antalya, Turkey.
University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Gynecologic Oncology, Antalya, Turkey.
Turk J Obstet Gynecol. 2021 Mar 12;18(1):15-22. doi: 10.4274/tjod.galenos.2021.36418.
To determine obstetrician-gynecologists' (OBGYNs) practice patterns regarding human papillomavirus (HPV) testing in cervical cancer screening. Secondly, we aimed to examine OBGYNs' adherence to guidelines in the management of women with HPV-positive test results.
The study was a cross-sectional survey conducted in Antalya and Istanbul provinces in Turkey using a self-reported questionnaire. A 12-item questionnaire form was administered to the participants in face-to-face interviews. Of the targeted participants, 343 OBGYNs completed the questionnaire.
The majority of participants, (81.0%) stated that they offered/used HPV testing in cervical cancer screening. Of those, most OBGYNs (89.9%) preferred to use HPV testing concomitant with cervical cytology (co-testing) whereas only 10.1% preferred to use HPV testing alone (primary HPV testing). The most preferred screening intervals for women with HPV-negative results were 5 years (53.4%) and 3 years (19.9%), respectively. In compliance with the guidelines, the rate of participants who recommended "referral directly to colposcopy" for women who were HPV16/18-positive and cytology-negative; and "co-testing at 12 months" for women who were positive for HPV genotypes other than HPV16/18 and cytology-negative was 53.1%. Multivariate analysis revealed that the "professional working setting" was the sole independent determinant of the adherence to the guidelines. OBGYNs working in private settings had the worst adherence rate (42.4%).
Primary HPV testing is not yet widespread among Turkish OBGYNs. Moreover, adherence to practice guidelines in the management of HPVpositive test results is relatively low. There is a need for continuing medical education regarding screening programs and the management of women with positive screening results.
确定妇产科医生在宫颈癌筛查中进行人乳头瘤病毒（HPV）检测的实践模式。其次，我们旨在研究妇产科医生在管理HPV检测结果呈阳性的女性时对指南的遵循情况。
本研究是在土耳其安塔利亚省和伊斯坦布尔省进行的一项横断面调查，采用自填式问卷。通过面对面访谈向参与者发放一份包含12个条目的问卷。目标参与者中有343名妇产科医生完成了问卷。
大多数参与者（81.0%）表示他们在宫颈癌筛查中提供/使用了HPV检测。其中，大多数妇产科医生（89.9%）倾向于将HPV检测与宫颈细胞学检查同时进行（联合检测），而只有10.1%的人倾向于单独使用HPV检测（HPV初筛）。HPV检测结果为阴性的女性最常选择的筛查间隔分别是5年（53.4%）和3年（19.9%）。根据指南，对于HPV16/18呈阳性且细胞学检查为阴性的女性，推荐“直接转诊至阴道镜检查”；对于HPV16/18以外的HPV基因型呈阳性且细胞学检查为阴性的女性，推荐“12个月后联合检测”，遵循这一建议的参与者比例为53.1%。多因素分析显示，“专业工作环境”是遵循指南的唯一独立决定因素。在私立机构工作的妇产科医生遵循率最低（42.4%）。
HPV初筛在土耳其妇产科医生中尚未广泛应用。此外，在管理HPV检测阳性结果时对实践指南的遵循率相对较低。有必要针对筛查项目以及筛查结果呈阳性的女性的管理开展继续医学教育。
