Obstetrician-gynecologists' practice patterns regarding HPV testing in cervical cancer screening in Turkey

Turk J Obstet Gynecol. 2021 Mar 12;18(1):15-22. doi: 10.4274/tjod.galenos.2021.36418.


Objective: 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.

Materials and methods: 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.

Results: 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%).

Conclusion: 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.

Keywords: Cervical cancer; HPV test; human papillomavirus.