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Kanker payudara (KPD) masih merupakan masalah kesehatan pada wanita baik di negara maju maupun di negara berkembang. Di Indonesia kanker payudara merupakan penyakit keganasan kedua terbanyak juga sering menyebabkan kematian. Selain itu, banyak penelitian di Indonesia yang menyatakan bahwa penderita kanker payudara mengobati penyakitnya ke rumah sakit atau ke dokter setelah penyakit masuk dalam stadium lanjut.Keberhasilan pengobatan kanker payudara lazim digambarkan dengan ketahanan hidup 5 tahun (five year survival rate). Selain aspek pengobatan, banyak faktor yang mempengaruhi ketahanan hidup 5 tahun penderita KPD seperti stadium, ukuran tumor, penyebaran tumor, aspek patologi, aspek sosial ekonomi, dan aspek lainnya. Sampai saat ini penelitian tentang ketahanan hidup 5 tahun pada penderita kanker payudara di RS Kanker Dharmais belum pemah dilakukan. Namun, jumlah penderita kanker payudara pertahunnya cukup banyak (menempati urutan 1 pada kasus rawat inap tahun 2000).Tujuan penelitian ini adalah untuk memperoleh informasi tentang ketahanan hidup 5 tahun penderita kanker payudara serta faktor-faktor yang berhubungan dengan ketahanan hidup 5 tahun di Rumah Sakit Kanker Dharmais. Penelitian ini menggunakan rancangan studi longitudinal. Data yang dikumpulkan berasal dari data rekam medik penderita KPD tahun 1993 sampai tahun 1996. Sampel berjumlah 137 penderita. Cara pengumpulan data adalah dengan observasi data rekam medik serta media komunikasi via telepon atau surat untuk mengetahui ketahanan hidup 5 tahun penderita KPD.Hasil penelitian ini menunjukkan bahwa probabilitas ketahanan hidup 5 tahun penderita kanker payudara sebesar 48% dan median ketahanan hidup 54 bulan. Probabilitas ketahanan hidup penderita kanker payudara pada stadium dini operable (I-IIIA) adalah 72% dan stadium lanjut (IIIB dan. IV) adalah 12%. Jika dibanding dengan stadium dini operabel, risiko untuk meninggal pada stadium lanjut sebesar 2,3 kali (95% CI: 1,228; 4,163). Probabilitas ketahanan hidup 5 tahun penderita kanker payudara pada ukuran tumor < 5 cm adalah 81%, dan ukuran tumor lebih dari 5 cm adalah 24%. Jika dibanding dengan ukuran tumor < 5 cm risiko meninggal pada ukuran tumor > 5 cm adalah 3,7 kali (95% CI: 1,803; 7,770). Probabilitas ketahanan hidup 5 tahun dengan pengobatan lengkap adalah 69% dan pengobatan tidak lengkap adalah 13%. Risiko meninggal penderita dengan pengobatan tidak lengkap adalah 3,3 kali (95%CI: 1,950; 5,572) dibanding dengan pengobatan lengkap.Berdasarkan hasil penelitian ini kepada tenaga medis diharapkan dapat meningkatkan penanganan kanker payudara dengan mengupayakan deteksi dini pada penderitanya. Selain itu perlu dorongan dari tenaga medis dan bantuan konseling agar penderita dapat mengikuti prosedur pengobatan dengan teratur dan lengkap. Kepada wanita terutama yang telah berumur di atas 20 tahun disarankan untuk melakukan SADARI (perikSA payuDAra sendiRl) setiap bulannya sehingga dapat segera mengetahui kelainan yang timbul pada payudaranya. Kepada pemerintah perlu diupayakan peningkatan KIE (Komunikasi Informasi Edukasi) dengan penyebaran informasi lewat media massa tentang penyakit kanker payudara.
Breast cancer is still a health problem for women in developed countries and developing countries. In Indonesia, number of breast cancer cases is high, the second cause of deaths after cervical cancer. In the other hand many researches in Indonesia report that the breast cancer patients go to hospitals or doctors after late stage.The successful breast cancer therapy was usually measured by using a five-year survival rate. Besides therapeutically aspects, many factors are involved in five-year survival rate namely: stage, tumor size, metastases, pathological aspects, socioeconomic aspects and etc. The annual number of the breast cancer patients is high (the first rank from all cancer type in 2000). However, until] now, no studies of five-year survival rate on RSKD have been done.The goal of this research is to find the probability of 5 year survival of the breast cancer patients in Dharmais Cancer Hospital Jakarta and the relationship between some other factors and 5 year survival rate. The design of this research is longitudinal study. Data are collected from the medical record breast cancer patients on 1993 toI996. The sample is I37 persons. The method of data collecting is observing of the medical record and telephoning or posting to find out the survival of breast cancer patient.The result shows that 5 year survival rate on breast cancer patient is 48%, the median of the survival rate is 54 months. The 5 years survival rate on early operable stage is 72% and on the late stage is 12%. By using the early operable stage as a baseline comparison, the risk ratio of the deaths for the late stage is 2,3 (95% CI: 1,228; 4,163). Moreover the 5 year survival rate on the less than 5 cm is 81% and more than 5 cm is 24%. If compared to size < 5 cm, the risk ratio of the deaths on patients with tumor size 5 cm is 3,7 (95% CI: 1,803; 7,770). The 5 year survival rate on patients with a complete therapy is 69% and an incomplete therapy is 13%. The risk of the deaths on the patients with the incomplete therapy is 3,3 times (95% CI: 1,950; 5,572) compared to the complete therapy.Based on this study, It is recommended that doctors/medicians be able to increase the ability to handle breast cancer cases by doing early detections to the suffers. Moreover the supports for medical professionals and counseling professional are needed so that the patients are able to follow the procedure of treatments regularly and completely. It is suggested that it is important to do SADARI monthly of women above 20. The government should increase to do EIC (Education, Information, and Communication) by spreading EIC materials through mass media about breast cancer.
Kata Kunci: Kanker Payudara; Riwayat Reproduksi
Breast cancer is the most common death in woman. DKI Jakarta has the highest prevalence of breasr cancer in Indonesia. The aim of this study is to find out the association between reproductive factors and breast cancer in woman at DKI Jakarta using the analysis Riskesdas 2013 data. The type of this study is cross sectional study with chi square analysis. Sample of this study is woman in DKI Jakarta age ≥ 30 who became sample in Riskesdas 2013. Based on this study, the risk factors of breast cancer are age at 1st live birth ≥ 25 tahun (PRR= 1,76; 95% CI: 0,53-5,84), parity (PRR= 1,06; 95% CI:0,32-3,54) , and breastfeeding status (PRR= 1,83; 95% CI: 0,23-14,17).
Keywords: Breast Cancer; Reproductive Factor
dependent Infant survival is defined as the ability of infants to survive through life up to 1 year old. Infant survival is the opposite of infant mortality is the death that occurred between after birth until the baby has not exactly 1 year old. In 2012, Indonesia IMR reported as 32 per 1,000 live births. This figure is relatively high compared to the Asia countries with similar socio-economic conditions. Moreover, the gap of IMR also occurred in socio-economic level within Indonesia. Socio-economic status is the primary factor determining survival of infants. Socio-economic status will affect infant survival through maternal factors, nutrition, baby's condition at birth, disease control and environment. This study aims to reveal the infant survival in Indonesia and its determinants based on data IDHS 2012. This study uses Indonesia Demographic and Health Survey 2012. The result shows that probability of infant survival in Indonesia amounted to 97,8%. Infant survival decreased sharply in the first months of age 1, wherein the proportion of infant deaths in the neonatal period amounted to 53.8% and neonatal deaths occurred in the age of 0-7 days, by 80%. Based on the results of time-dependent Cox regression, the variables entered into the multivariate model were maternal age when gave birth (20-35 years, HR = 1.9), Maternal employment (officer/employee, HR = 2.2; informal sector/industrial, HR = 3.3 ; agriculture, HR = 2.1), birth weight (<2500 grams, HR = 5.9; not weigh, HR = 2.0), prelakteal feeding (HR = 1.5), post-delivery checked (not checked, HR = 2.2). There is interaction between time with the effects of low birth weight and post- delivery checked in the multivariate model obtained. Keywords : Infant survival, infant death, socio-economics, neonatal, cox time dependent regression
