Ankara Med J. 2020; 20(1): 1-10 | DOI: 10.5505/amj.2020.52296

Evaluation of HPV incidence and cervical smear results in Syrian refugees

Murat Alan¹, Muhammet Ali Oruç², Nisel Yýlmaz¹, Hakký Aytaç³, Muzaffer Sancý¹, Yasemin Alan^3
1Department Of Obstetrics And Gynecology, Universty Of Health Sciences Tepecik Education And Research Hospital, Ýzmir, Turkey;
²Department Of Family Medicine, Faculty Of Medicine, Ahi Evran University, Kirsehir, Turkey
³Department Of Obstetrics And Gynecology, Ýzmir Metropolitan Municipality Eþrefpaþa Hospital, Ýzmir, Turkey

INTRODUCTION: The aim of this study was to determine the rate of HPV and cervical pathologies in Syrian women admitted to the gynecology-oncology outpatient clinic.
METHODS: 659 Syrian refugee patients admitted to the gynecology oncology outpatient clinic between January 2014 and September 2018 were included in the study. Pregnant women, women who underwent a hysterectomy, and those with a history of HPV vaccine were excluded from the study. Demographic data [age, socioeconomic status, educational status, smoking habits, parity, age of first intercourse, body mass index (BMI)] and clinical information (cervical smear, HPV genotype and cervical biopsy results) of the patients were evaluated. The statistical significance level was accepted as p <0.05.
RESULTS: During the study period, a total of 659 Syrian women who meet our study criteria admitted to our clinic. The mean age of Syrian patients included in the study was 25.13 ± 4.20 years, 23.60 % were married before the age of 18, and the educational status of 73.50% of patients were at high school and above. HPV DNA positivity was found in 5.30% (35/659) of the Syrian refugee women. In our study, HPV 16 was found in 22.80% (8/35); HPV 18 was positive in 17.60% (6/35); and other high-risk types were seen in 59.60% of patients. 97.60% of the patients (643/659) had normal smear results, while 1.40% (9/659) had ASCUS; 0.30% (2/659) had ASCH; 0.60% (4/659) had LSIL; and HSIL was present in 0.10% (1/659) of patients.
DISCUSSION AND CONCLUSION: The rate of HPV in Syrian patients was similar to women in our country, and the most common (except HPV 16 and 18) are other types of high-risk HPV. Considering that the Syrian citizens will stay in our country for a longer period of time, more effective cervical cancer screening programs should be applied to the Syrian women who have already suffered from great difficulties and the information deficiencies about vaccination must be eliminated.

Keywords: Syrian patients, HPV, cervical smear, cervical biopsy

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Suriyeli mültecilerde HPV insidansý ve servikal smear sonuçlarýnýn deðerlendirilmesi

Murat Alan¹, Muhammet Ali Oruç², Nisel Yýlmaz¹, Hakký Aytaç³, Muzaffer Sancý¹, Yasemin Alan^3
1Saðlýk Bilimleri Üniversitesi Tepecik Eðitim Araþtýrma Hastanesi
²Ahi Evran Üniversitesi Aile Hekimliði Abd
³Ýzmir Büüykþehir Belediyesi Eþrefpaþa Hastanesi

GÝRÝÞ ve AMAÇ: Çalýþmamýzýn amacý, jinekoloji onkoloji polikliniðine baþvuran Suriyeli kadýnlarda HPV oranýný saptamak, servikal patolojileri tespit etmektir.
YÖNTEM ve GEREÇLER: Jinekoloji Onkoloji Polikliniði’ne Ocak 2014 ile Eylül 2018 tarihleri arasýnda baþvuran 659 Suriyeli göçmen hasta çalýþmaya dahil edildi. Gebe olanlar, histerektomi operasyonu geçirenler, HPV aþý öyküsü olanlar çalýþma dýþý býrakýldý. Hastalarýn demografik verileri [yaþ, sosyoekonomik düzey, eðitim durumu, sigara alýþkanlýðý, parite, ilk iliþki yaþý, vücut kitle indeksi (BMI)] ve klinik bilgileri (servikal smear, HPV genotip ve servikal biyopsi sonuçlarý) deðerlendirildi. Verilerin istatistiksel analizleri yapýldý. Ýstatistiki anlamlýlýk düzeyi p<0,05 olarak kabul edildi.
BULGULAR: Çalýþma süresi boyunca, kliniðimize çalýþma kritelerimizi saðlayan toplam 659 Suriyeli kadýn hasta baþvurdu. Çalýþmaya alýnan Suriyeli göçmen hastalarýn yaþ ortalamalarý 25,13±4,20, %23,60’sýnýn 18 yaþ öncesi evlendikleri, %73,50’si lise ve üzeri öðrenim düzeyinde olduðu tespit edildi. Suriyeli göçmen kadýnlarýn (35/659) %5,30’unde HPV DNA pozitifliðine rastlandý. Çalýþmamýzda HPV 16 (8/35) %22,80; HPV 18 (6/35) %17,60; diðer yüksek riskli HPV tipleri %59,60 oranýnda görüldü. Hastalarýn (643/659) %97,60’ýnde smear sonucu normal; (9/659) %1,40’ýnda ASCUS; (2/659) %0,30’unda ASCH; (4/659) %0,60’ýnda LSIL; (1/659) %0,10’unda HSIL mevcuttu.
TARTIÞMA ve SONUÇ: Suriyeli hastalarda bulunan HPV oranlarý ülkemizdeki kadýnlara benzer orandaydý ve en sýk bulunan tipler HPV 16 ve 18 dýþýndaki tiplerdi. Ülkemizde, Suriyeli göçmen kadýnlarýn daha uzun sürede kalacaklarý düþünüldüðünde zaten büyük sýkýntýlar çeken bu hastalara daha etkin servikal kanser tarama programlarý yapýlmasý ve aþýlama hakkýndaki bilgi eksikliklerini giderilmesi gerekmektedir.

Anahtar Kelimeler: Suriyeli hastalar, HPV, servikal smear, servikal biyopsi

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