{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:24:41Z","timestamp":1787235881528,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate colposcopy performance following the human papillomavirus (HPV) DNA screening program in Turkey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women aged 30\u201365\u2009years are screened for cervical cancer every 5\u2009years, with individuals positive for HPV 16 and\/or 18 or other high\u2010risk HPV types with abnormal cytology referred for colposcopy. Both HPV test and cytology are obtained at the same visit. If HPV is negative, cytology will not be assessed. However, if HPV is positive, both cytology and HPV genotyping will be performed. Colposcopy\u2010require was defined as HPV 16\/18 positivity or abnormal smear results with any hrHPV positivity, and the remaining patients (normal smear with hrHPV positivity other than HPV 16\/18) were grouped as colposcopy non\u2010required. National data on colposcopy outcomes and unnecessary performance rates in February 2018\u20132019 were evaluated via a questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 9808 patients were included, divided based on colposcopy requirement: 5751 (58.6%) patients required colposcopy and 4057 (41.4%) did not. Unnecessary colposcopy was performed on 90.1% of the non\u2010required group (3657 of 4057 patients). In the colposcopy\u2010required group, 4455 patients (79.9%) underwent punch biopsy; 3194 (57.1%), endocervical curettage (ECC); and 421 (7.5%), \u201csee and treat\u201d\u00a0in the non\u2010required group, the results were 2790 (76.3%), 1957 (53.2%), and 211 (5.7%), respectively. A total of 746 cervical intraepithelial neoplasia (CIN)\u20103 isolates were detected, including 702 using existing screening and triage with 94.1% sensitivity (702\/746). Multiple biopsies were taken in 69.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093110) of patients from the colposcopy\u2010required group and 63.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091777) from the non\u2010required group. The ECC samples included 19 cervical cancers and 212 \u2265CIN\u20103 lesions in the colposcopy\u2010required group, and four cancers and 41 \u2265CIN\u20103 lesions in the non\u2010required group. The proportion of \u2265CIN\u20103 lesions detected by ECC only was 4.7% (35 of 746 \u2265CIN\u20103 lesions).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results showed high rates of unnecessary colposcopies, and a high percentage of multiple and random punch biopsies and ECC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.6740","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T19:31:57Z","timestamp":1700854317000},"page":"21751-21760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of colposcopy after the addition of human papillomavirus testing to the Turkish cervical cancer screening program"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-2720","authenticated-orcid":false,"given":"Ali Can","family":"Gunes","sequence":"first","affiliation":[{"name":"Mamak State Hospital Department of Obstetrics and Gynecology  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nejat","family":"Ozgul","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology Hacettepe University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Turky\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Cancer Control Turkish Ministry of Health, Public Health Institute  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Cancer Control Turkish Ministry of Health, Public Health Institute  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahriye","family":"Unlu","sequence":"additional","affiliation":[{"name":"Department of Cancer Control Turkish Ministry of Health, Public Health Institute  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ayhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baskent University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4221-4459","authenticated-orcid":false,"given":"Murat","family":"Gultekin","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology Hacettepe University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.10400"},{"key":"e_1_2_9_4_1","first-page":"2020","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health O","year":"2020"},{"key":"e_1_2_9_5_1","unstructured":"Dairesi TCSBK.Serviks Kanseri Tarama Program\u0131 Ulusal Standartlar\u0131 2014.https:\/\/hsgm.saglik.gov.tr\/depo\/Mevzuat\/Genel_Nitelikli_Yazi_ve_Gorusler\/Serviks_Kanseri_Tarama_Programi_Ulusal_Standartlari.pdf. 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