A Study on the Utility of Screening Tests in Squamous Cell Carcinoma (SCC) and High-grade Intraepithelial Lesions (HSIL) of the Cervix: Evaluation of 447 Cases with Histopathological Diagnosis

Süheyla Ekemen; Davut Şahin; Sadik Toprak; Ebru Bilir; Meryem Akbaş; Ümit İnce; Serkan Erkanlı

doi:10.31067/acusaglik.1392641

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A Study on the Utility of Screening Tests in Squamous Cell Carcinoma (SCC) and High-grade Intraepithelial Lesions (HSIL) of the Cervix: Evaluation of 447 Cases with Histopathological Diagnosis

Year 2024, , 317 - 325, 01.07.2024

Süheyla Ekemen , Davut Şahin , Sadik Toprak , Ebru Bilir , Meryem Akbaş , Ümit İnce , Serkan Erkanlı

https://doi.org/10.31067/acusaglik.1392641

Abstract

Introduction:
Cervical cancer is one of the most common cancers in women. Precancerous lesions of the cervix
can be detected with the combined use of smear testing and HPV (Human Papillomavirus)
testing. International guidelines have been developed to indicate at what intervals and in which
situations the tests should be performed. In this study, we examined the clinical utility of screening tests in patients with histopathologically diagnosed SCC (squamous cell carcinoma) and HSIL.
Metods:
Between January 2022 and June 2023, 447 patients aged 19-73 years (mean 37) with cervical
biopsy results of SCC and HSIL were evaluated for the use of diagnostic tests (PAP smear and
HPV test).
Results:
PAP smears were performed in 98.2% and HPV tests in 39.1% of all cases before histopathologic
diagnosis. The most frequently detected high-risk HPV (hrHPV) was type 16. HPV testing
significantly decreased with age. HPV testing was not performed in 74.2% of patients aged 51-
60 years and 80.9% of patients over 60 years.
Conclusion:
These cases the clinical utility and pathologic evaluation of the PAP smear were optimal. However, HPV testing practice was decreasing, especially with age. Cytologic evaluation may be misleading due to age-related hormonal withdrawal, difficulty in obtaining adequate smears, and atrophic changes. Our recommendation is to use HPV testing in all age groups, but especially in the population over 50 years of age, where cytologic difficulties may occur, HPV testing should be performed optimally until 65 years of age.

Keywords

HSIL, SCC, HPV, hrHPV, PAP SMEAR, ELDERLY WOMAN

Thanks

S.E. is a Clinical Fellow of the Takeda Science Foundation and greatly acknowledges educational support from them.

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