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<\/div>\nK\u0131br\u0131s T\u00fcrk Tabipleri Birli\u011fi (KTTB) Y\u00f6netim Kurulu \u00fcyesi Do\u00e7. Dr. Hanife \u00d6zkayalar, HPV( Human Papilloma Vir\u00fcs) a\u015f\u0131s\u0131n\u0131n ulusal a\u015f\u0131 takvimine eklenmesi ve devlet g\u00fcvencesiyle \u00fccretsiz olarak uygulanmas\u0131 gerekti\u011fini belirtti.<\/p>\n
\u00d6zkayalar, toplum sa\u011fl\u0131\u011f\u0131n\u0131n korunmas\u0131 ve HPV\u2019ye (Human Papilloma Vir\u00fcs) ba\u011fl\u0131 hastal\u0131klar\u0131n \u00f6nlenmesi amac\u0131yla a\u015f\u0131lama programlar\u0131n\u0131n yayg\u0131nla\u015ft\u0131r\u0131lmas\u0131 gerekti\u011fini kaydetti.<\/p>\n
Konuyla ilgili yaz\u0131l\u0131 a\u00e7\u0131klama yapan \u00d6zkayalar, d\u00fcnya genelinde 150\u2019ye yak\u0131n \u00fclkede ulusal a\u015f\u0131lama program\u0131 kapsam\u0131nda \u00fccretsiz HPV a\u015f\u0131s\u0131 uyguland\u0131\u011f\u0131n\u0131 dile getirerek, bu \u00fclkelerin 42 tanesinde de k\u0131z ve erkek \u00e7ocuklar\u0131n cinsiyet ayr\u0131m\u0131 yap\u0131lmaks\u0131z\u0131n a\u015f\u0131land\u0131\u011f\u0131n\u0131 belirtti.<\/p>\n
A\u015f\u0131laman\u0131n her hastal\u0131k i\u00e7in, en \u00f6nemli koruyucu sa\u011fl\u0131k hizmeti olarak tan\u0131mland\u0131\u011f\u0131n\u0131 kaydeden \u00d6zkayalar, koruyucu hekimlik uygulamalar\u0131n\u0131n etkin ve kapsay\u0131c\u0131 bir \u015fekilde d\u00fczenli olarak s\u00fcrd\u00fcr\u00fclmesinin, hem HPV\u2019ye ba\u011fl\u0131 kanserlerin, hem de di\u011fer sa\u011fl\u0131k sorunlar\u0131n\u0131n \u00f6n\u00fcne ge\u00e7mek i\u00e7in kritik bir \u00f6neme sahip oldu\u011funu ifade etti.<\/p>\n
-\u201cHPV tipleri, d\u00fc\u015f\u00fck riskli ve y\u00fcksek riskli olarak iki gruba ayr\u0131l\u0131r\u201d<\/p>\n
Hanife \u00d6zkayalar, HPV (Human Papilloma Vir\u00fcs), cinsel yolla bula\u015fan, insan deri ve mukozas\u0131nda enfeksiyonlara neden olan, 200\u2019den fazla farkl\u0131 tipi bulunan bir vir\u00fcs oldu\u011funu i\u015faret ederek, HPV tiplerinin d\u00fc\u015f\u00fck riskli ve y\u00fcksek riskli olarak iki gruba ayr\u0131ld\u0131\u011f\u0131n\u0131 kaydetti.<\/p>\n
Y\u00fcksek riskli HPV tiplerinin yakla\u015f\u0131k 14 adet oldu\u011funu dile getiren \u00d6zkayalar, \u015fu ifadeleri kulland\u0131:<\/p>\n
\u201c\u00d6zellikle HPV 16 ve HPV 18 bunlar\u0131n i\u00e7erisinde en y\u00fcksek riske sahiptir, tekrarlayan ve kal\u0131c\u0131 enfeksiyonlarla, onkogenetik de\u011fi\u015fikliklere yol a\u00e7arak serviks (rahim a\u011fz\u0131) ba\u015fta olmak \u00fczere anal, a\u011f\u0131z\/bo\u011faz, ba\u015f, boyun ve penis kanserlerinin geli\u015fiminde \u00f6nemli bir rol oynar. D\u00fc\u015f\u00fck Riskli HPV t\u00fcrleri ise genellikle genital si\u011fillere neden olur ve kanser geli\u015fiminde do\u011frudan bir rol\u00fc g\u00f6sterilmemi\u015ftir. En yayg\u0131n g\u00f6r\u00fclen d\u00fc\u015f\u00fck riskli tipler ise HPV 6 ve HPV 11\u2019dir. HPV\u2019nin serviks kanseri ile olan ili\u015fkisi bilimsel olarak kan\u0131tlanm\u0131\u015ft\u0131r, bu kanser t\u00fcr\u00fc \u00f6zellikle geli\u015fmekte olan \u00fclkelerin kad\u0131nlar\u0131nda en s\u0131k g\u00f6r\u00fclen kanserlerden biridir. 2022 y\u0131l\u0131 istatistiksel verilerine bak\u0131ld\u0131\u011f\u0131nda \u00fclkemizde 30-65 ya\u015f aras\u0131 kad\u0131n n\u00fcfusu 77,398; serviks kanseri olgu say\u0131s\u0131 15 (6,7\/100,000 ki\u015fi) iken buna ek olarak in situ lezyona (kanser \u00f6nc\u00fc hastal\u0131k) sahip olgu say\u0131s\u0131 ise 5\u2019tir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) t\u00fcm \u00fclkelere, serviks kanserinin erken tan\u0131s\u0131 i\u00e7in HPV testi ve PAP smear testi ile toplum bazl\u0131 taramalar\u0131n yap\u0131lmas\u0131n\u0131 \u00f6nermektedir. Serviks kanseri, kanserle\u015fme s\u00fcrecinin \u00f6nc\u00fcl a\u015famalar\u0131nda veya erken evrede tespit edildi\u011finde tedavi ba\u015far\u0131s\u0131 \u00e7ok y\u00fcksektir. Verilerimizin y\u0131llar i\u00e7erisindeki da\u011f\u0131l\u0131m\u0131 incelendi\u011finde toplum bazl\u0131 taramalara \u00f6nem verildik\u00e7e hastal\u0131klar\u0131n kanser olmadan in situ lezyon a\u015famas\u0131nda tespit edilen olgu say\u0131s\u0131n\u0131n artt\u0131\u011f\u0131 g\u00f6r\u00fclmektedir.\u201d<\/p>\n
-\u201c PAP smear ve HPV tarama testleri ve HPV a\u015f\u0131lar\u0131n\u0131n, koruyucu sa\u011fl\u0131k hizmetlerinin temel ta\u015flar\u0131\u201d<\/p>\n
HPV enfeksiyonlar\u0131n\u0131n neden oldu\u011fu kanser \u00f6nc\u00fcs\u00fc lezyonlar\u0131n \u00f6nlenmesi, belirlenmesi ve basit y\u00f6ntemlerle tedavi edilmesinin \u00f6nemli bir halk sa\u011fl\u0131\u011f\u0131 konusu oldu\u011funu kaydeden \u00d6zkayalar, bu noktada PAP smear ve HPV tarama testleri ve HPV a\u015f\u0131lar\u0131n\u0131n, koruyucu sa\u011fl\u0131k hizmetlerinin temel ta\u015flar\u0131n\u0131 olu\u015fturdu\u011funu belirtti.<\/p>\n
PAP smear testinin, serviksten d\u00f6k\u00fclen h\u00fccrelerin mikroskop alt\u0131nda incelenmesine dayanan bir test oldu\u011funu dile getiren \u00d6zakayalar, \u015fu ifadelere yer verdi:<\/p>\n
\u201c\u00d6rnekleme jinekolog taraf\u0131ndan yap\u0131l\u0131r ve patolog taraf\u0131ndan de\u011ferlendirilerek servikste anormal h\u00fccre varl\u0131\u011f\u0131 ara\u015ft\u0131r\u0131l\u0131r. Toplum bazl\u0131 taramalarda 21 ya\u015f itibariyle PAP smear taramas\u0131na ba\u015flanmal\u0131, sonucu negatif oldu\u011fu takdirde test \u00fc\u00e7 y\u0131lda bir tekrarlanmal\u0131d\u0131r. Yine toplum bazl\u0131 taramalarda 25 ya\u015f ve \u00fczeri kad\u0131nlarda, PAP smear testine ek olarak HPV tiplendirmesi yap\u0131lmas\u0131 da \u00f6nerilmektedir. Kotest olarak isimlendirilen bu y\u00f6ntemde her iki testin sonucu negatif ise, tarama aral\u0131\u011f\u0131 be\u015f y\u0131lda bir olarak belirlenir.\u201d<\/p>\n
-\u201c HPV a\u015f\u0131s\u0131, y\u00fcksek riskli HPV t\u00fcrlerine kar\u015f\u0131 primer korunma sa\u011flamak amac\u0131yla geli\u015ftirildi\u201d<\/p>\n
HPV a\u015f\u0131s\u0131, y\u00fcksek riskli HPV t\u00fcrlerine kar\u015f\u0131 primer korunma sa\u011flamak amac\u0131yla geli\u015ftirildi\u011fini kaydeden \u00d6zkayalar, tedavi edici \u00f6zelli\u011fi bulunmad\u0131\u011f\u0131n\u0131 ifade etti.<\/p>\n
\u00d6zkayalar \u015f\u00f6yle devam etti:<\/p>\n
\u201c\u0130\u00e7erdi\u011fi HPV tiplerinin yapabilece\u011fi kal\u0131c\u0131 enfeksiyonlara engel olmak i\u00e7in dizayn edilmi\u015ftir. A\u015f\u0131 canl\u0131 virus ya da virus DNA\u2019s\u0131 i\u00e7ermedi\u011fi i\u00e7in hastal\u0131k yapamaz. \u00d6nemli bir yan etki profili de yoktur. A\u015f\u0131n\u0131n 2\u2019li, 4\u2019l\u00fc ve 9\u2019lu tipleri vard\u0131r. \u0130kili a\u015f\u0131 en yayg\u0131n olarak kanser yapan tiplere yani HPV 16 ve HPV 18\u2019e kar\u015f\u0131 antigen i\u00e7erir. D\u00f6rtl\u00fc a\u015f\u0131 bu tiplere ek olarak en s\u0131k genital si\u011fil yapan HPV 6 ve HPV11\u2019e kar\u015f\u0131 antigen i\u00e7erir, yani hem rahim a\u011fz\u0131 kanserine, hem de genital si\u011fillere kar\u015f\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k olu\u015fturmak \u00fczere haz\u0131rlanm\u0131\u015ft\u0131r. Dokuzlu a\u015f\u0131da ise bu d\u00f6rt tipe ek olarak rahim a\u011fz\u0131 kanseri a\u00e7\u0131s\u0131nda y\u00fcksek risk i\u00e7eren 5 HPV tipi daha eklenmi\u015f olup, kapsay\u0131c\u0131l\u0131\u011f\u0131 y\u00fczde 90\u2019a y\u00fckselmi\u015ftir. A\u015f\u0131lar\u0131n i\u00e7erdi\u011fi tiplere kar\u015f\u0131 koruyuculu\u011fu y\u00fczde 100\u2019d\u00fcr\u201d<\/p>\n
-\u201cHedef d\u00f6nem 9-15 ya\u015f\u201d<\/p>\n
A\u015f\u0131n\u0131n, esas olarak 9 \u2013 15 ya\u015f \u00e7ocuklara ve gen\u00e7lere yani HPV naif, HPV ile kar\u015f\u0131la\u015fmam\u0131\u015f populasyona yap\u0131lmak \u00fczere hem kad\u0131n hem erkeklere \u00f6nerildi\u011fini s\u00f6yleyen \u00d6zkayalar, bu d\u00f6nemin hedef d\u00f6nem ve olu\u015fan koruyuculu\u011fun en \u00fcst d\u00fczeyde oldu\u011funu kaydetti.<\/p>\n
\u00d6zkayalar, a\u015f\u0131larlar ilgili \u015fu ifadeleri kulland\u0131:<\/p>\n
\u201cA\u015f\u0131lama 15 ya\u015f\u0131ndan g\u00fcn almam\u0131\u015f gen\u00e7lerde iki doz halinde 0 ve 6. aylarda, daha b\u00fcy\u00fck kad\u0131n ve erkeklerde ise \u00fc\u00e7 doz halinde 0, 2 ve 6. aylarda yap\u0131l\u0131r. A\u015f\u0131 koldan ve kas i\u00e7ine uygulan\u0131r. A\u015f\u0131, her ya\u015fta yap\u0131labilir ancak yap\u0131ld\u0131\u011f\u0131 ya\u015f grubuna g\u00f6re koruyucu etkinli\u011fi de\u011fi\u015fir.\u201d<\/p>\n<\/p><\/div>\n