Program-level evaluation of population-based HPV screening in Van, Türkiye: screening activity, test positivity, genotype distribution and follow-up data capture in a retrospective record-based study

Abstract Background Province-level evidence on the implementation of population-based HPV screening in eastern Türkiye remains limited. This study aimed to describe screening activity relative to the programme-defined target population, HPV test positivity, recorded genotype patterns, histopathological diagnoses, and available follow-up information within the cervical cancer screening programme in Van Province. Methods This retrospective, record-based programme evaluation used aggregated programme data from 2022 through the first two months of 2026 and individual-level records for HPV-positive women from 2023–2025. Annual screening activity ratios were calculated using programme-defined target populations. Age and recorded genotype distributions were described among HPV-positive women. Histopathological diagnoses and referral-related information were reported as available programme records because individual-level linkage and complete pathway denominators were unavailable. Temporal change in programme HPV test positivity was assessed using the Cochran-Armitage trend test. Results Across the study periods, annual screening counts summed to 94,123 records, with 2,078 HPV-positive results (2.21%). The screening activity ratio increased from 17.1% in 2022 to 95.5% in 2024 and decreased to 67.9% in 2025. Observed programme HPV test positivity declined from 3.17% in 2022 to 1.80% in 2025 (p for trend < 0.001). Among 1,810 HPV-positive women with individual-level data, the mean age was 44.5 years. HPV16 was the most frequently recorded specific genotype (36.4%), HPV16 and/or HPV18 was recorded in 43.8%, and at least one recorded oncogenic genotype targeted by the nine-valent vaccine was identified in 55.4%. Multiple specifically identified HPV genotypes were recorded in 16.5%. Programme records contained 394 histopathological diagnoses during 2023–2025, including three invasive cervical cancer records. Available follow-up data did not permit calculation of referral, hospital attendance, colposcopy, biopsy, or treatment completion rates. Conclusions HPV screening activity in Van varied substantially across years, while observed programme test positivity declined during 2022–2025; this decline should not be interpreted as evidence of reduced population HPV prevalence. Recorded genotype findings were dominated by HPV16, but variation in type-specific reporting limits temporal interpretation. Improved standardization of genotype reporting and individual-level linkage across screening, referral, diagnosis, histopathology, and treatment would strengthen programme monitoring.