ENDONÜÇ PROJECT 13-YEAR-OLD ENDOMETRIOSIS SCREENING PROTOCOL

Abstract

Technical Area: This study specifically focuses on a screening and clinical evaluation system developed for screening for endometriosis in adolescent girls, identifying at-risk individuals and referring them to gynecologists, thus enabling early diagnosis of endometriosis. The problem that needs to be solved: Endometriosis, the most significant pathological cause of severe dysmenorrhea (painful menstruation) and chronic pelvic pain in adolescents, severely restricts individuals' daily physical and psychosocial functioning. Endometriosis is a chronic and progressive disease with an average diagnosis time of 7-10 years from the onset of the first symptoms. The main reasons for this significant delay in diagnosis are as follows: 1. Definitive diagnosis often requires invasive / surgical methods. 2. The fact that classic diagnostic parameters specific to the adult age group (infertility and dyspareunia / painful intercourse) are not applicable to the adolescent population, which is around 13 years of age, 3. The acceptance and normalization of painful menstruation during adolescence as "normal" by society and / or healthcare providers. These factors often lead to undiagnosed cases in adolescence, causing significant diagnostic delays within the healthcare system. Solution to the problem: Early diagnosis of endometriosis is critical to preventing disease progression, the development of chronic pelvic pain, and long-term sequelae (infertility, etc.). In this regard, age groups where all individuals have regular and predictable contact with the health system offer a strategic window of opportunity for effective community-based screening. In Turkey, under the National Childhood Immunization Schedule, the adult-type diphtheria-tetanus (Td) booster vaccine is routinely administered at age 13, and this vaccination is carried out in family health centers. Therefore, age 13 is an important period when healthy girls are re-engaged with the health system in a planned manner and benefit from routine preventive health services.This application could be used as an opportunity to evaluate an easy, quick, low-cost, and acceptable endometriosis screening test that can be administered during the same visit. This would allow for the identification of potential cases before the disease reaches advanced stages and referral of girls requiring further evaluation to appropriate healthcare facilities. Characteristics of the proposed method: Neither in our country nor in foreign literature is there a standardized screening questionnaire / system specific to the adolescent age group and suitable for integration into routine preventive health services. In this study, a standard endometriosis screening questionnaire, suitable for integration into primary health care services and at a level appropriate to the perception of 13-year-old girls, was prepared to identify individuals at risk for endometriosis. The questionnaire consists of a total of 9 questions: 6 aimed at determining the presence of the disease, and 3 aimed at determining its severity and the extent to which it impairs functionality. As previously mentioned, this program is not intended for diagnosis, but rather a decision support and risk scoring algorithm that classifies adolescents as high-risk and low-risk and directs them to medical services. This project is named the ENDONÜÇ PROJECT, inspired by combining the first four letters of "endometriosis" with the age of 13. The patent application in question is being filed to patent this project and the screening questionnaire.