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Kanker serviks uteri masih menjadi masalah kesehatan masyarakat di Indonesia. Kejadian kanker serviks uteri sebesar 12,6/100000 wanita dan angka kematiannya sebesar 7,0/100000 wanita (IARC, 2008). Hal ini dimungkinkan karena faktor resiko yang masih belum tertangani di masyarakat. Multi paritas (khususnya paritas > 4 kali) atau jumlah melahirkan pada wanita sebagai salah satu faktor resiko kanker serviks uteri ternyata masih tinggi di masyarakat. Penelitian ini ingin mengetahui pengaruh paritas > 4 kali terhadap kejadian kanker serviks uteri di 6 rumah sakit Indonesia. Penelitian dilakukan dengan desain kasus kontrol berbasis rumah sakit, dengan sampel sebanyak 364 wanita yang telah dipasangkan berdasarkan asal rumah sakit dan umur interval 10 tahun. Analisis multivariat menggunakan conditional logistic regression. Hasil menunjukkan bahwa paritas > 4 meningkatkan resiko kanker serviks uteri OR: 1,85 ; CI 95% (1,14 -3,02). Oleh karenanya usaha untuk pengembangan program yang dapat membatasi kelahiran seperti program Keluarga berencana akan membantu menurunkan terjadinya kasus serviks uteri.
High-risk Human Papillomavirus (HR-HPV) is the necessary factor for the development of cervical cancer. The use of hormonal contraception has been associated with HR-HPV risk infection. However, the existing study results are not conclusive. There is very limited relevant data available in Indonesia. Hence, this study is aimed to evaluate the association between the use of hormonal contraceptives and infection risk of HR-HPV based on data from a 2019 screening program held by Indonesian Cancer Foundation, Jakarta branch, in Jakarta. This is a case-control study using secondary data from a cervical cancer screening program in Jakarta during January-December 2019. The case group is subjects with positive HPV-DNA test results from Hybrid Capture 2. The control group is randomly selected from the screening participants with negative HPV-DNA test results, with a ratio with the case is 2:1, and frequency matched based on area of domicile. Data is analyzed using multivariate analysis, unconditional logistic regression. The number of case in this study is 172 and 344 subjects in the control group. The prevalence of HR-HPV infection from the whole screening program is 6,56%. Most study participants were not using any kind of contraception methods (62,79% cases; 49,13% control). The risk of HR-HPV is crude OR 0,64 (95% CI 0,39-1,04, p=0,06) and adjusted OR 0,97 (95% CI 0,53-1,79; p=0,93). in current user of hormonal contraceptives. Whilst the association in the past users of hormonal contraception prior the test is crude OR 0,55 (95%CI 0,37-0,83; p=0,002) and adjusted OR 0,53 (95% 0,34-0,82; p=0,005). There is no significant association between the current user of hormonal contraceptives and the risk of HR-HPV infection. On the other hand there is a significant negative association in the past user group.
Kanker leher rahim merupakan penyakit berbahaya pada wanita yang dapat ditangani semenjak awal dengan melakukan deteksi dini. Capaian deteksi dini kanker leher rahim di Indonesia yang rendah menyebabkan peningkatan angka kesakitan dan kematian akibat kanker leher rahim. Puskesmas Batuceper merupakan salah satu puskesmas di Kota Tangerang dengan capaian deteksi dini kanker leher rahim metode IVA terendah pada tahun 2022. Penelitian ini bertujuan untuk mengetahui determinan perilaku wanita usia 30-50 tahun dalam melakukan deteksi dini kanker leher rahim metode IVA di Puskesmas Batuceper tahun 2024 berdasarkan teori Health Belief Model (HBM). Desain penelitian menggunakan studi cross-sectional. Data dikumpulkan dengan metode wawancara menggunakan kuesioner kepada 172 wanita usia 30-50 yang dipilih dengan teknik consecutive sampling. Data dianalisis secara univariat, bivariat dan multivariat dengan uji regresi logistik ganda. Hasil penelitian menunjukkan 11,6% wanita usia 30-50 tahun telah melakukan deteksi dini metode IVA dalam 3 tahun terakhir. Faktor yang berhubungan dengan perilaku deteksi dini kanker leher rahim metode IVA adalah persepsi hambatan dan isyarat bertindak, dimana persepsi hambatan merupakan faktor yang paling dominan. Responden dengan persepsi hambatan yang rendah memiliki peluang 4,68 kali untuk melakukan deteksi dini kanker leher rahim metode IVA dibandingkan responden dengan persepsi hambatan yang tinggi setelah dikontrol oleh isyarat bertindak (aOR=4,68 95% CI 1,45-15,10). Oleh karena itu, penting dilakukan upaya untuk mengurangi hambatan dan meningkatkan isyarat bertindak dengan memperluas kegiatan pemberian edukasi dan informasi mengenai bahaya kanker leher rahim serta pentingnya pemeriksaan IVA kepada calon pengantin, suami/pasangan, orangtua siswa di sekolah serta lintas sektor. Kata Kunci: Deteksi Dini, Kanker Leher Rahim, Health Belief Model, Puskesmas
Cervical cancer is a dangerous disease in women that can be treated early by screening. The low achievement of cervical cancer screening in Indonesia has led to an increase in the incidence of pain and death from cervical cancer. The Batuceper Health Center is one of the health centers in Tangerang City with the lowest achievement of cervical cancer screening with IVA method in 2022. This study aims to determine the behavioral determinants of women aged 30-50 in conducting early detection of cervical cancer using the IVA method at the Batuceper Health Center in 2024 based on the Health Belief Model (HBM) theory. The research design uses a cross-sectional study. Data was collected by interview method using a questionnaire to 172 women aged 30-50 who were selected using consecutive sampling techniques. The data were analyzed univariately, bivariate, and multivariate with multiple logistic regression tests. The results showed that 11.6% of women aged 30-50 had successfully detected the IVA method early in the last 3 years. Factors related to the behavior of early detection of cervical cancer IVA method are the perception of obstacles and action signals, where the perception of obstacles is the most dominant factor. Respondents with a low perception of obstacles had 4.68 times the chance of cervical cancer screening with IVA method compared to respondents with a high perception of obstacles after being controlled by action signals (aOR=4.68, 95% CI 1.45-15.10). Therefore, it is important to make efforts to reduce the barriers and increase action signals by expanding education and information activities about the dangers of cervical cancer as well as the importance of IVA examination to brides-to-be, husbands/partners, and parents of students at school and across sectors. Keywords: Screening, Cervical Cancer, Health Belief Model, Health Center