Drs. Yilmaz and Marshall are paid consultants to Avedro, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

Objective: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. Material and Method:Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared.Results: Th e mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. Th ere was significant diff erence with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively Th e most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). Conclusion:In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women. Bulgular: Ortalama hasta yaşı 38.9±10.2 idi. Tüm grup değerlendiril-diğinde, %25 hastada HPV pozitif olarak saptandı. Anormal sitolojisi olanlarda HPV pozitifl iği %57 iken normal pap testi olanlarda HPV pozitifl iği %27 oranında tespit edildi. Hastaların yaşam dekadları ile HPV pozitifl iği arasında anlamlı bir ilişki bulundu (p<0,05) HPV pozitifl iği ASCUS, ASC-H, LSIL, HSIL, glandüler anormallikler ve skuamöz hücreli karsinom için sırasıyla %37, %9, %27, %20, %22, %41 idi. En sık görülen HPV tipleri sırasıyla HPV 16 (%32), HPV 6 (%17), HPV 11 (%9), HPV 18 (%8), HPV 31 (%6), HPV 51 (%5), HPV 33 (%3) idi.Sonuç: Bu hastane temelli retrospektif analizde HPV tipleri gelişmiş batı ülkelerinde rapor edilen tiplerle benzer olarak tespit edildi. Ülkemizdeki gerçek popülasyon temelli HPV prevalansı ve tiplerinin belirlenmesi için hastane temelli olmayan çok merkezli geniş sayıda hasta içeren serilere ihtiyaç vardır.

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To compare the prevalence of cervical human papillomavirus (HPV) infection in Turkish women with normal Papanicolaou (Pap) smear and cervical intraepithelial neoplasia (CIN). In between March 2002 and November 2005, the study was designed as case-control study. Cytologic abnormalities in Pap smears were classified according to the Bethesda System (2001). Identification of the presence of HPV was carried out by the Hybrid Capture II test for all patients. To compare the groups, Chi-square test was used. A total of 1353 reproductive aged women were screened. Of them, 1344 (99.3%) had normal or class I Pap smear. Remaining nine cases (0.7%) had CIN at several degrees (five CIN I, three CIN II, and one carcinoma in situ). While all these nine cases with cervical pathologies had HPV, only 20 cases from the other group (1.5%) had HPV (chi(2) 466.1; P = 0.0001). This is the first study of the evaluation of the association between HPV and preinvasive cervical lesions in Turkish population. In spite of low general frequency (2.1%) of cervical HPV colonization in this population, a strong correlation was found between HPV and CIN.