title: What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts.
abstract: OBJECTIVE
  There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories.
  
  
  METHODS
  In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire.
  
  
  RESULTS
  The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers.
  
  
  CONCLUSIONS
  There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.
authors.affiliation: Department of Pathology, Istanbul Medipol University Faculty of Medicine, İstanbul.
authors.forename: İlknur Çetinaslan
authors.initials: İÇ
authors.lastname: Türkmen
authors.forename: Alp
authors.initials: A
authors.lastname: Usubütün
authors.forename: Aslı
authors.initials: A
authors.lastname: Çakir
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Aydin
authors.forename: Filiz Aka
authors.initials: FA
authors.lastname: Bolat
authors.forename: Metin
authors.initials: M
authors.lastname: Akbulut
authors.forename: Serdar
authors.initials: S
authors.lastname: Altinay
authors.forename: Sema
authors.initials: S
authors.lastname: Arici
authors.forename: Figen
authors.initials: F
authors.lastname: Aslan
authors.forename: Müzeyyen
authors.initials: M
authors.lastname: Astarci
authors.forename: Emine Kılıç
authors.initials: EK
authors.lastname: Bağir
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Baş
authors.forename: Nuray
authors.initials: N
authors.lastname: Başsüllü
authors.forename: Betül
authors.initials: B
authors.lastname: Çelik
authors.forename: Handan
authors.initials: H
authors.lastname: Çetiner
authors.forename: Bengü
authors.initials: B
authors.lastname: Çobanoğlu
authors.forename: Abdullah
authors.initials: A
authors.lastname: Aydin
authors.forename: Hale
authors.initials: H
authors.lastname: Demir
authors.forename: Hayriye Tatlı
authors.initials: HT
authors.lastname: Doğan
authors.forename: Kamile Gülçin
authors.initials: KG
authors.lastname: Eken
authors.forename: Selma Şengiz
authors.initials: SŞ
authors.lastname: Erhan
authors.forename: Gülgün
authors.initials: G
authors.lastname: Erdoğan
authors.forename: Kıvılcım Eren
authors.initials: KE
authors.lastname: Erdoğan
authors.forename: Funda
authors.initials: F
authors.lastname: Eren
authors.forename: Şafak
authors.initials: Ş
authors.lastname: Ersöz
authors.forename: Pınar
authors.initials: P
authors.lastname: Firat
authors.forename: İclal
authors.initials: İ
authors.lastname: Gürses
authors.forename: Nihan
authors.initials: N
authors.lastname: Haberal
authors.forename: Dudu Solakoğlu
authors.initials: DS
authors.lastname: Kahraman
authors.forename: Gülçin Harman
authors.initials: GH
authors.lastname: Kamali
authors.forename: Yasemin Yuyucu
authors.initials: YY
authors.lastname: Karabulut
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kefeli
authors.forename: Meral
authors.initials: M
authors.lastname: Koyuncuoğlu
authors.forename: R Doğan
authors.initials: RD
authors.lastname: Köseoğlu
authors.forename: Bahar
authors.initials: B
authors.lastname: Müezzinoğlu
authors.forename: Binnur
authors.initials: B
authors.lastname: Onal
authors.forename: Sevgen
authors.initials: S
authors.lastname: Önder
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Özcan
authors.forename: Elife
authors.initials: E
authors.lastname: Kimiloğlu
authors.forename: Hatice
authors.initials: H
authors.lastname: Özer
authors.forename: F Cavide
authors.initials: FC
authors.lastname: Sönmez
authors.forename: Sevinç
authors.initials: S
authors.lastname: Şahin
authors.forename: Nurhan
authors.initials: N
authors.lastname: Şahin
authors.forename: Tülin
authors.initials: T
authors.lastname: Yalta
mesh_terms: D055088:Early Detection of Cancer / Q000592:standards*; D005260:Female; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D011786:Quality Control; D014421:Turkey / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D014626:Vaginal Smears / Q000592:standards*