Hasil Pencarian  ::  Simpan CSV :: Kembali

"Tahun 2012, kanker serviks merupakan kanker terbanyak keempat yang diderita perempuan di dunia dan merupakan kanker terbanyak kedua di Indonesia. Pencegahan kanker serviks dapat dilakukan dengan deteksi dini. Tahun 2007 Indonesia menerapkan program skrining IVA (Inspeksi Visual Asam asetat) sebagai bentuk deteksi dini kanker serviks. Penelitian ini menggunakan desain studi ekologi dengan provinsi sebaga unit agregat. Data sekunder yang digunakan berasal dari subdirektorat penyakit kanker, Kementerian Kesehatan dengan variabel terikat cakupan skrining IVA dan variabel bebas tenaga kesehatan, puskesmas IVA, kasus IVA positif, kasus IVA positif yang dikrioterapi, dan curiga kanker serviks. Korelasi kuat ditujukan antara persentase kasus IVA positif yang dikrioterapi dengan cakupan skrining IVA (Rs=0,661; p=0,001) dan antara curiga kanker serviks dengan cakupan skrining IVA (Rs=0,549; p=0,001). Meningkatnya cakupan IVA akan meningkatkan pengobatan segera kanker serviks. Untuk meningkatkan cakupan skrining IVA diperlukan kurikulum pendidikan skrining IVA untuk pendidikan dokter dan kebidanan.

---

In 2012 cervical cancer is the fourth highest cancer suffered by women in the world and is the second largest cancer in Indonesia. Cervical cancer can be prevented by early detection. In 2007, Indonesia implemented a screening programe named VIA (Visual Inspection Acetic Acid) for early detection for cervical cancer. This study uses the ecological design with Province as the aggregate unit. We used secondary data from subdit cancer, Ministry of Health Republic of Indonesia with the dependent variable of VIA screening coverage and independent variables of health personnel, VIA health centers, VIA positive, Cryoteraphy for VIA positive, and suspected of cervical cancer. The strong correlation shows between the percentage of positive VIA with cryoteraphy and coverage VIA screening (Rs=0,661; p= 0,001) and among suspected of cervical cancer with coverage of cervical cancer VIA screening (Rs= 0,549; p= 0,001). The increase of VIA coverage will improve immediate treatment for cervical cancer. To improve VIA screening we required educational curriculum for medical education and midwifery."

"ABSTRAK LATAR BELAKANG: Kanker serviks merupakan kanker dengan insidensi kedua tertinggi pada wanita. Skrining yang tidak adekuat merupakan penyebab tingginya kanker serviks di Indonesia dan 70 penderita datang ke rumah sakit pada stadium lanjut. IVA merupakan metode skrining sederhana, murah dengan sensitivitas tinggi yang cocok diterapkan di Indonesia dan DKI Jakarta merupakan daerah yang tepat dijadikan model untuk mengetahui permasalahan kanker serviks di Indonesia. Female Cancer Program FCP bersama FKUI aktif melakukan skrining kanker serviks dengan metode IVA sejak tahun 2004. Belum diketahui berapa capaian skrining kanker serviks dengan metode IVA di Jakarta tahun 2004-2010TUJUAN: mendapatkan gambaran capaian skrining kanker serviks oleh FCP di berbagai wilayah di Jakarta tahun 2004-2010METODE: Penelitian ini merupakan penelitian deskriptif HASIL: Capaian skrining kanker serviks dengan metode IVA di Jakarta tahun 2004-2010 adalah 31236 perempuan atau 0.86 persen dari populasi perempuan di DKI Jakarta usia 15 hingga >60 tahun. Proporsi terbanyak 60.07 persen adalah skrining di wilayah Jakarta Timur diikuti 24.41 persen wilayah Jakarta Pusat, 8.42 persen Jakarta Utara, 4.02 persen Jakarta Selatan dan 3.08 persen Jakarta Barat. Skrining berbasis Puskesmas baru mencakup 45 dari total 340 Puskesmas di DKI Jakarta, 7 Puskesmas di Jakarta Pusat dan 38 Puskesmas di Jakarta Timur. Proporsi menurut usia peserta skrining terbanyak pada kelompok usia 30-39 tahun yaitu 38 persen . Proporsi temuan IVA positif adalah 1138 atau 3.68 persen dimana 3.14 persennya merupakan temuan di wilayah Jakarta Timur. Temuan kanker adalah 0.08 persen atau 80/100000 perempuan.SIMPULAN: Skrining kanker serviks dengan metode IVA telah berhasil dilakukan di Jakarta pada 31.236 perempuan pada periode 2004-2010 dan IVA merupakan metode paling tepat dikembangkan di Jakarta dan Indonesia pada umumnyaKATA KUNCI: Capaian, IVA, Kanker serviks, Skrining

---

ABSTRACTAbstract Objective To evaluate the coverage of a cervical cancer screening program based on visual inspection with acetic acid VIA testing conducted during 2004 to 2010 in Jakarta.Methods We used data obtained from the Female Cancer Program FCP . Cervical cancer screening participation rates were calculated.Results A total of 31,236 women participated in the program. The participation rate of the program was 0.86 .Conclusion The participation rate of the program was low. Efforts to facilitate participation in cervical cancer screening program among Indonesian women are needed. Further studies assessing factors that influence attendance in cervical cancer screening program are required."

"Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang dapat meningkatkan akurasi tes IVA dalam mendeteksi lesi derajat tinggi kanker serviks. Metode: Dua puluh lima subjek dilakukan pemeriksaan IVA, dimana didapatkan hasil IVA positif dan dinilai lima kriteria berdasarkan kecepatan muncul lesi, intensitas warna putih yang kuat, ketebalan lesi berbentuk plak, batas lesi yang tegas dan tepi lesi yang meninggi. Kemudian dilakukan biopsi pada lesi putih yang dihasilkan dan dilakukan pemeriksaan histopatologi. Hasil histopatologi dikelompokkan menjadi lesi derajat tinggi dan non lesi derajat tinggi. Hasil: Penelitian ini diikuti oleh 25 wanita dengan hasil IVA positif Didapatkan NPP untuk kriteria kecepatan muncul lesi ≤60 detik, ketebalan lesi berbentuk plak, intensitas warna putih yang kuat, batas lesi yang tegas dan tepi lesi yang meninggi, adalah masing-masing sebesar 0,36; 0,33; 0,18; 0,2 dan 0,09. Apabila dua kriteria IVA positif dengan NPP tertinggi, yaitu kecepatan muncul lesi dan ketebalan lesi bentuk plak digabungkan, akan meningkatkan NPP menjadi 0,40. Kesimpulan: Di antara lima kriteria IVA positif yang diuji pada penelitian ini, yang mempunyai nilai prediksi positif paling baik dalam mendeteksi lesi derajat tinggi adalah kriteria kecepatan munculnya lesi dan ketebalan lesi berbentuk plak.

---

Objective: To know the factors that can increase the accuracy of VIA tests in detecting high grade lesions.

Study design: Twenty-five subjects were performed VIA test with positive results, assessed further by five criterias based on speed of the lesion appear, strong white intensity of the lesions, thick lesions with plaque-shaped, firm-bordered lesions, and rised-edged lesions. Then punch biopsy and histopathology examination were conducted. Histopathology results grouped into high grade lesions and non-high grade lesions.

Results: This research followed by 25 woman with VIA positive results. Obtained PPV for five criterias: speed of lesions appear less than 60 seconds, strong white intensity of the lesions, the thickness of lesions with plaque-shaped, firm-bordered lesions, and rised-edged lesions were respectively 0.36; 0.33; 0.18; 0.2 and 0.09. If 2 criterias with best PPV, speed of lesions appear less than 60 seconds and the thickness of lesions with plaque-shaped, were combined, it will improve PPV to 0.40.

Conclusion: Among five criterias of VIA positive tested in the research, 2 criterias with best predictive values in detecting high grade lesions are speed of lesions appear less than 60 seconds and thick lesions with plaque-shaped."

"Latar Belakang Kanker serviks menempati urutan kedua sebagai kanker yang paling sering terjadi pada wanita Indonesia. Penyakit tersebut umumnya disebabkan oleh infeksi Human papillomavirus (HPV). Temuan kelainan serviks (prakanker dan kanker serviks) dapat dicegah dengan vaksinasi HPV dan deteksi dini kelainan dengan pemeriksaan Inspeksi Visual Asam Asetat (IVA). Untuk itu, tujuan penelitian ini adalah untuk mengetahui apakah vaksinasi HPV dan pemeriksaan IVA memiliki hubungan terhadap temuan kelainan serviks pada pasien Poliklinik Ginekologi dan Onkologi RSCM tahun 2021-2022. Metode Desain penelitian ini adalah potong lintang. Data sekunder diambil dari hasil wawancara pasien yang berkunjung ke Poliklinik Ginekologi dan Onkologi RSCM. Hasil Pada penelitian ini, subjek penelitian yang diikutsertakan berjumlah 193 subjek. Pada analisis data, hubungan vaksinasi HPV dengan temuan kelainan serviks (prakanker dan kanker serviks) didapatkan p-value 0,005 (bermakna secara statistik) dengan OR 0,022 (95% CI 0,002 – 0,194). Selanjutnya, hubungan pemeriksaan IVA dan temuan kelainan serviks didapatkan p-value 0,14 (tidak bermakna secara statistik) dengan OR 0,24 (95% CI 0,041 – 1,392). Kesimpulan Vaksinasi HPV ditemukan memiliki hubungan yang signifikan dengan temuan kelainan serviks. Sementara itu, pemeriksaan IVA ditemukan tidak memiliki hubungan yang signifikan. Faktor tersebut sebenarnya sangat berperan dalam pencegahan temuan kelainan serviks. Hasil yang tidak signifikan tersebut kemungkinan disebabkan oleh keterbatasan penelitian, seperti jumlah sampel sedikit dan karakteristik sampel yang homogen.

---

Introduction Cervical cancer is the second most common cancer in Indonesian women. This disease is generally caused by Human papillomavirus (HPV) infection. Therefore, cervical abnormalities findings (precancerous and cervical cancer) can be prevented by HPV vaccination and early detection of abnormalities with Visual Inspection with Acetic Acid (VIA) screening. For this reason, the purpose of this study was to determine whether HPV vaccination and IVA examination have an association with cervical abnormalities findings in patients at the RSCM Gynecology and Oncology Clinic 2021-2022. Method The design of this study was cross-sectional. Secondary data was collected by interviewing patients who visited the RSCM Gynecology and Oncology Clinic. Results In this study, the total number of research subjects was 193 subjects. In the data analysis, the association between HPV vaccination and cervical abnormalities findings (precancerous and cervical cancer) was found to have a p-value of 0.005 (statistically significant) with an OR of 0,022 (95% CI 0,002 – 0,194). Meanwhile, the association between VIA screening and cervical abnormalities findings was found to have a p-value of 0.14 (not statistically significant) with an OR of 0.24 (95% CI 0.041 – 1.392). Conclusion HPV vaccination were found to have a significant association with cervical abnormalities findings. Meanwhile, VIA screening were not found to have a significant association with cervical abnormalities findings. However, these factors play a very important role in preventing cervical abnormalities. The insignificant results are likely due to the limitations of the study, such as small sample size and homogenous sample characteristics."

"Kanker serviks merupakan penyakit kanker dengan pervalensi tertinggi kedua pada perempuan di Indonesia. Deteksi dini kanker serviks metode IVA merupakan program preventif prioritas pemerintah Indonesia dalam pengendalian kanker serviks, namun cakupan pemeriksaannya masih rendah. Penelitian ini bertujuan untuk mengetahui determinan perilaku deteksi dini kanker serviks dengan metode IVA pada WUS usia 30-50 tahun. Penelitian ini menggunakan desain cross-sectional, data dikumpulkan melalui wawancara menggunakan kuesioner kepada 180 WUS dan dianalisis menggunakan uji chi-square dan regresi logistik ganda. Hasil penelitian menunjukkan 22,8 WUS melakukan deteksi dini metode IVA. Penelitian ini membuktikan pengetahuan, keterpaparan informasi dan dukungan tenaga kesehatan berhubungan dengan perilaku deteksi dini kanker serviks metode IVA, sementara pendidikan, akses kepelayanan kesehatan dan dukungan suami sebagai konfonding pada hubungan tersebut. Keterpaparan informasi merupakan faktor dominan, WUS yang terpapar informasi mengenai kanker serviks berpeluang 13,8 kali lebih tinggi untuk melakukan deteksi dini kanker serviks metode IVA dibandingkan WUS yang tidak terpapar informasi setelah dikontrol pendidikan, akses kepelayanan skrining dan dukungan suami p=0,013, OR:13, 869, 95 CI:1,723-111,650. Sedangkan pekerjaa dan asuransi kesehatan tidak berhubungan dengan perilaku deteksi dini kanker serviks metode IVA. Instansi terkait perlu melakukan upaya intervensi komunikasi informasi dan edukasi berupa penyuluhan dan penyebaran media promosi terkait kanker serviks dan tes IVA untuk meningkatkan jumlah WUS yang terpapar informasi.

---

Cervical cancer is cancer with the highest prevalence in Indonesia women. Early detection of cervical cancer VIAmethod is the government 39 s priority preventive program in controlling cervical cancer, but the coverage of the examination is still low. This study aimed to determine the determinants of the behavior of early detection of cervical cancer with VIA method in women of childbearing age of 30 50 years. This study used cross sectional design, data was collected through interviews using questionnaires to 180 samples and analyzed using chi square test and multiple logistic regression test.

The results showed 22.8 of childbearing age women perform early detection of cervical cancer VIA method. These finding revealed that knowledge, information exposure and support of health care related to early detection of cervical cancer VIA method, while education, access to health care and husband support as confounding. Information exposure is a dominant factor, childbearing age women exposed to information about cervical cancer had 13.8 times chance to early detection of cervical cancer VIA method than unexposed information after being controlled by education, screening service access and husbands support p 0,013, OR 13, 869, 95 CI 1,723 111,650. Meanwhile, work and health insurance are not related to the behavior of early detection of cervical cancer VIA method. Relevant institutions need to make efforts communication, information and education in the form socialization and dissemination of promotion media related to cervical cancer and VIA test to increase the number of childbearing age women exposed information."

"ABSTRAKMenikah usia dini dan berganti pasangan seksual merupakan faktor resiko pentingkejadian lesi prakanker serviks yang kemudian berubah menjadi kanker serviks.Kabupaten Karawang dipilih sebagai tempat penelitian karena merupakan salahsatu pilot project program deteksi dini kanker serviks dengan metode IVA.Penelitian ini bertujuan untuk mengetahui gambaran dan hubungan antara usiapertama menikah dan jumlah pasangan seksual terhadap hasil tes IVA dengandesign cross sectional menggunakan data sekunder sebanyak 520 sampel di 4puskesmas pada tahun 2011 – 2012. Berdasarkan analisis multivariat tidakdidapatkan hubungan yang bermakna antara usia pertama menikah dan jumlahpasangan seksual dengan hasil tes IVA positif setelah dikontrol variabel kovariat.

---

ABSTRACTThe age at first intercourse and multi sexual patners are the important risk factorsfor cervical pre-cancerous lession. Karawang District was selected as researchsites because it is one of the pilot projects for early detection of cervical cancerusing VIA Method. This study is aimed to verify the relationship of age at firstmarriage and multi sexual patners with VIA Test Result with cross sectional studyusing secondary data from medical records. Total sampel taken was 520 from 4public health centre in the last two years from 2011 – 2012. Based on multivariateanalysis, it is indicated that there is not significant correlation for age at firstmarriage and multi sexual partners with VIA test res"

"Latar Belakang: Tingginya angka prevalensi kanker serviks di Indonesia membuat pemerintah Indonesia berupaya untuk menurunkan angka kasus kanker serviks melalui program Deteksi Dini Kanker Serviks. Inspeksi Visual Asam Asetat (IVA) merupakan suatu metode pemeriksaan visual seluruh permukaan leher rahim menggunakan asam asetat yang diencerkan dengan tujuan untuk mengetahui dini adanya kanker serviks.Tujuan: Melihat gambaran implementasi dari program deteksi dini kanker serviks menggunakan metode Inspeksi Visual Asam Asetat (IVA) yang ada di Puskesmas Kecamatan Pancoran Mas.Metode: Penelitian ini menggunakan metode kualitatif dengan wawancara mendalam melalui pendekatan rapid assessment procedures. Teori yang digunakan adalah teori logic model. Informan dalam penelitian berjumlah 19 orang yang terdiri dari 4 informan kunci dan 15 informan utama. Peneliti mengambil data secara langsung dengan menerapkan protocol Covid-19.Hasil: Sebagian besar pelaksanaan program IVA telah berjalan sesuai alur yang ditetapkan oleh Kementerian Kesehatan. Namun terdapat beberapa hambatan dalam pelaksanaannya yaitu terdapat tenaga pelaksana yang belum terlatih tetapi dapat memberikan IVA, kurangnya kesadaran masyarakat untuk melakukan IVA serta pemberian penyuluhan terkait IVA di Puskesmas Kecamatan Pancoran Mas masih sedikit. Kesimpulan: Pemberian penyuluhan terkait IVA di Puskesmas Kecamatan Pancoran Mas perlu ditingkatkan lagi untuk meningkatkan kesadaran masyarakat melakukan IVA agar tercapainya cakupan IVA sesuai target.

---

Background: High prevalence of cervical cancer in Indonesia makes Indonesian Government strive to reduce the number of cervical cancer cases through the cervical cancer early detection program. Visual inspection with acetic acid (IVA) is a method of visual inspection of the entire surface of the cervix using diluted acetic acid with the aim to detecting cervical cancer early.

Aim: Describing the implementation of Cervical Cancer Early Detection Program using Visual Inspection with Acetic Acid Method (VIA) at Public Health Center in Pancoran Mas District.

Methods: This study used a qualitative method with indepth interviews through a rapid assessment procedure approach with. There were 19 informants consisting of 4 key informants, 3 main informants, and 12 supporting informants. Researchers took data directly by applying the Covid-19 health protocol.

Result: Most of the implementation of IVA program had run according to the law set by the Ministry of Health. However, there are several obstacles in its implementation as there were untrained health workers who already gave an IVA test, lack of public awareness to do IVA test, and the provision of socialization related to IVA at Public Health Center in Pancoran Mas District was still small.

Conclusion: The provision of socialization related to IVA at Public Health Center in Pancoran Mas District needs to be increased again to increase awareness in public also the scope of IVA so the target can be achieved."

"ABSTRAKOne effort to reduce the prevalence of cervical cancer is by IVA Test, but the coverageof IVA Test in Bondongan Health Center is still low and has not reached the nationaltarget, in 2016 (9.9%), 2017 (0.8%). The research objective was to examine in depth aboutthe behavior of WUS (30-50 years) in conducting IVA Test in the work area ofBondongan Health Center. This research is a qualitative study with the Rapid AssessmentProcedure design. Data collection was done through Focus Group Discussion, In-depthInterviews and document review observations, carried out in March-May 2019 atBondongan Health Center and Bogor City Health Office. The results of the researchshowed that the knowledge of informants about cervical cancer and IVA Test waslacking. Access from home to health services is still affordable. The attitude and behaviorof the officers in providing IVA Test services are considered good. Cervical cancer is athreat to the health of informants and by carrying out IVA Test is known to have or notcervical cancer. Obstacles found in conducting IVA Test: 1) fear and shame at the timeof examination, and fear of examination results, 2) not having time to check because ofwork 3) not knowing information about IVA Test (schedule and costs) 4) no complaintsand WUS's knowledge is still lacking, 5) obstacles in terms of facilities: the IVA Testroom in Bondongan Health Center is narrow 6) barriers from officers: the number ofprograms held by each health worker and different work motivation. There is supportfrom husbands, health workers, friends, neighbors in conducting IVA Test. Disseminationof information by the Bondongan Community Health Center to WUS is still not optimaland uneven. There are already policies that regulate the management of IVA Testprograms at the national level (Kepmenkes and PMK) and at the regional/city level ofBogor (Perwal) including SOP

---

ABSTRACTOne effort to reduce the prevalence of cervical cancer is by IVA Test, but the coverageof IVA Test in Bondongan Health Center is still low and has not reached the nationaltarget, in 2016 (9.9%), 2017 (0.8%). The research objective was to examine in depth aboutthe behavior of WUS (30-50 years) in conducting IVA Test in the work area ofBondongan Health Center. This research is a qualitative study with the Rapid AssessmentProcedure design. Data collection was done through Focus Group Discussion, In-depthInterviews and document review observations, carried out in March-May 2019 atBondongan Health Center and Bogor City Health Office. The results of the researchshowed that the knowledge of informants about cervical cancer and IVA Test waslacking. Access from home to health services is still affordable. The attitude and behaviorof the officers in providing IVA Test services are considered good. Cervical cancer is athreat to the health of informants and by carrying out IVA Test is known to have or notcervical cancer. Obstacles found in conducting IVA Test: 1) fear and shame at the timeof examination, and fear of examination results, 2) not having time to check because ofwork 3) not knowing information about IVA Test (schedule and costs) 4) no complaintsand WUS`s knowledge is still lacking, 5) obstacles in terms of facilities: the IVA Testroom in Bondongan Health Center is narrow 6) barriers from officers: the number ofprograms held by each health worker and different work motivation. There is supportfrom husbands, health workers, friends, neighbors in conducting IVA Test. Disseminationof information by the Bondongan Community Health Center to WUS is still not optimaland uneven. There are already policies that regulate the management of IVA Testprograms at the national level (Kepmenkes and PMK) and at the regional/city level ofBogor (Perwal) including SOP."

"Kanker leher rahim merupakan kanker yang sering terjadi pada wanita, meliputi 12% dari seluruh kanker di dunia. Insiden yang tertinggi terjadi di Amerika Selatan dan Karibian, Sub Sahara Afrika, Asia Selatan dan Asia Tenggara. Di Indonesia menurut Kementerian Kesehatan RI, insiden kanker leher rahim di perkirakan 100 per 100.000. Ketahanan hidup 5 tahun penderita kanker leher rahim bila ditemukan pada stadium yang lebih awal, probabilitasnya semakin tinggi. Untuk stadium I (95,1-80,1%), II (66,3-63,5%), III (38,7-33,3%), IV (17,1-9,4%) dan pada masa pra invasif mencapai 100%. Di negara maju insidens dan kematian akibat kanker leher rahim turun 50-60% dalam 20 tahun karena 40-50% wanitanya pernah menjalani screening. Di negara berkembang sebaliknya terus naik karena hanya 5% wanitanya yang pernah menjalani screening.Metode Inspeksi Visual dengan Asam Asetat (IVA) telah diakui WHO efektif digunakan di negara berkembang dengan alasan sederhana, murah, nyaman, praktis dan mudah. Mempunyai sensitifitas 66-96% dan spesifisitas (64-98%). Kabupaten Karawang terpilih sebagai lokasi penelitian karena merupakan salah satu daerah pilot proyek deteksi dini kanker leher rahim. Dari bulan Juli 2007 - Maret 2010 ditemukan 2,3% kasus IVA positif. Kasus kanker leher rahim di Kabupaten Karawang tergolong tinggi dimana pada tahun 2005 dilaporkan 217 kasus dan tahun 2006 sampai dengan bulan September ditemukan 180 kasus. Sesuai etiologinya dua faktor risiko utama terjadinya kanker leher rahim adalah usia pertama kali berhubungan seksual dan jumlah pasangan seksual.Terkait faktor risiko berganti pasangan seksual, kasus kawin cerai di Karawang tinggi. Tahun 2008 tercatat 508 kawin, 259 cerai talak dan 424 cerai gugat. Tahun 2009 tercatat 270 talak dan 562 gugat. Terkait faktor risiko usia hubungan seksual, pernikahan muda di Karawang juga tinggi. Tahun 2007 42,8% pernikahan usia muda di Indonesia terjadi di pantai utara Jabar. Pernikahan di Jabar 35% dilakukan wanita dibawah usia 16 tahun.Penelitian ini bertujuan mengetahui hubungan usia pertama kali berhubungan seksual dan jumlah pasangan seksual dengan kejadian lesi pra kanker leher rahim pada wanita yang melakukan deteksi dini menggunakan metode Inspeksi Visual dengan Asam Asetat (IVA) di Puskesmas Cikampek, Pedes dan Kota Baru Kabupaten Karawang tahun 2009 ? 2010. Metode penelitian yang digunakan adalah studi analitik observasional dengan desain kasus kontrol. Faktor yang diteliti didapat melalui wawancara terstruktur dengan kuesioner. Sedangkan data kasus kontrol diambil dari buku register dan catatan medik di Puskesmas Cikampek, Pedes dan Kota Baru dalam 2 tahun terakhir 2009 ? 2010. Total sampel yang diambil adalah 357 yang terdiri dari 119 kasus dan 238 kontrol.Variabel independen yang diteliti adalah usia pertama kali berhubungan seksual dan jumlah pasangan seksual. Variabel kovariat terdiri dari umur, pendidikan, pekerjaan, pendapatan, riwayat kanker keluarga, jarak haid pertama kali dengan hubungan seksual pertama, kebiasaan merokok, jumlah batang rokok per hari, lama merokok, riwayat partus, riwayat abortus, penggunaan kontrasepsi, lama penggunaan kontrasepsi, riwayat deteksi dini sebelumnya, kebiasaan merokok pasangan, jumlah batang rokok per hari pasangan, lama merokok pasangan, riwayat perkawinan pasangan dan sirkumsisi. Analisis data dilakukan dengan soft ware SPSS versi 17.0 yang meliputi analisis univariat, bivariat, stratifikasi dan multivariat.Hasil penelitian mendapatkan ada hubungan yang bermakna antara usia pertama kali berhubungan seksual dengan kejadian lesi pra kanker leher rahim setelah di kontrol dengan variabel lain dengan p value 0,001 dan OR 2,539 (CI 95% 1,444 - 4,464) sedangkan dampak potensialnya AR% 60,61%. Untuk jumlah pasangan dengan kejadian lesi pra kanker leher rahim setelah di kontrol dengan variabel umur juga memiliki hubungan yang bermakna dengan p value 0,002 dan OR 3,441 (CI 95% 1,598 ? 7,410) sedangkan dampak potensialnya AR% 70,94%.Kesimpulan penelitian adalah risiko terkena lesi pra kanker leher rahim pada wanita yang memulai hubungan seksual pada usia < 17 tahun adalah 2,539 kali lebih tinggi dibanding mereka yang memulai hubungan seksual < 17 tahun dan kejadian lesi prakanker pada seorang wanita dapat dicegah 60,61% bila dia tidak melakukan hubungan seksual pertama < 17 tahun. Sedangkan untuk risiko terkena lesi pra kanker leher rahim pada wanita yang memiliki jumlah pasangan seksual > 1 orang adalah 3,441 kali lebih tinggi dibanding mereka yang mempunyai pasangan seksual 1 orang setelah di kontrol variabel umur dan kejadian lesi pra kanker pada seorang wanita dapat dicegah 70,94% bila dia tidak mempunyai jumlah pasangan seksual > 1.

---

Cervical cancer is the most common cancer in women, counting for 12% of all cancers in the world. The highest incidence occurred in South America and Karibian, Sub-Saharan Africa, South Asia and Southeast Asia. In Indonesia, according to the Ministry of Health, the incidence of cervical cancer is estimated occurred 100 per 100.000. The probability of 5-year survival of patients with cervical cancer when found at an earlier stage is higher. For stage I (95.1 to 80.1%), II (66.3 to 63.5%), III (38.7 to 33.3%), IV (17.1 to 9.4%) and in the pre-invasive reaches 100%. In developed countries the incidence and death from cervical cancer are decreased by 50-60% in the last 20 years since 40-50% women of those counties had undergone screening. In developing countries on the contrary, it continues to rise because only 5% women who had undergone screening.

Method of Visual Inspection with Acetic Acid (VIA) has been recognized by WHO effectively used in developing countries by reason of simple, inexpensive, convenient, practical and easy. The specifity of VIA method is 64-98% and sensitivity is 66-96%. Karawang District was selected as research sites because it is one of the pilot projects for early detection of cervical cancer. From July 2007 - March 2010 found 2.3% positive VIA cases. The cases of cervical cancer in the Karawang regency is high, where in 2005 was reported 217 cases and as of September 2006 was found 180 cases.

According to the etiology of two major risk factors for cervical cancer is the age at first intercourse and multisexual partners. In relation to risk factors of sexual partner change, a divorce & marriage case in Karawang is high. In 2008 it was recorded 508 marriage, 259 divorces and 424 divorce claim. In 2009 there were 270 divorces and 562 divorce claim. Concerning to age-related risk factors for sexual intercourse, young marriages in Karawang are also high. In 2007 42.8% marriage of young age in Indonesia was occurred in the northern coast of West Java. Marriage in West Java which is done by women under the age of 16 years was counted as 35%.

This study is aimed to verify the relationship of age at first intercourse and multisexual partners with cervical pre-cancerous lesions in women doing early detection using Visual Inspection with Acetic Acid (VIA) in Cikampek, Pedes and Kota Baru Public Health Center of Karawang District in 2009 - 2010. The research method used was an observational analytic study with case control design. Factors studied were obtained through structured interviews with questionnaires. While the case-control data were taken from the book registers and medical records at Cikampek, Pedes and Kota Baru Public Health Center in the last two years from 2009 to 2010. Total samples taken was 357 consisting of 119 cases and 238 controls.

Independent variables studied were age at first intercourse and multisexual partners. Kovariat variables consisted of age, education, occupation, income, family history of cancer, distance of first menstruation to first intercourse, smoking habits, number of cigarettes per day, duration of smoking, history of parturition, and abortion history, contraceptive use, duration of use of contraception, previous history of early detection, smoking spouse, the number of cigarettes per day couples, duration of couples smoking, history of marriage partners and circumcision. Data analysis was performed with SPSS version 17.0 software which includes univariate, bivariate, and stratification and multivariate analysis.

The results of study find significant relationship between age at first sexual intercourse with cervical pre-cancerous lesions after being controlled with other variables with p value of 0.001 and OR 2.539 (95% CI 1.444 - 4.464), while the potential impact of AR% 60.61%. For the number of sexual pairs with cervical precancerous lesions after being controlled with variables of age also have a meaningful relationship with p value of 0.002 and OR 3.441 (95% CI 1.598 - 7.410) while the potential impact of AR%, 70.94%.

The conclusion is the risk of cervical pre-cancerous lesions in women who began sexual intercourse at age <17 years is 2.539 times higher than those who start a sexual intercourse at age < 17 years and the incidence of precancerous lesions in a woman could be prevented 60.61% if she does not have first sexual intercourse before 17 years. While for the risk of cervical pre-cancerous lesions in women who have a number of sexual partners more than 1 person is 3.441 times higher than those who have only one sexual partners after being controlled by variables of age and the incidence of precancerous lesions in a woman can be prevented 70.94 % if she does not have the number of sexual partners more than 1."

"Kanker leher rahim merupakan kanker nomer dua terbanyak diderita oleh perempuan di seluruh dunia dan penyebab kematian akibat kanker yang paling utama, khususnya bagi perempuan di negara-negara berkembang (WHO, 2002). Prevalensi kanker leher rahim di wilayah DKI Jakarta sebesar 1,2 dari 5.919 pada wanita yang melakukan skrining dan Provinsi Jawa Barat sebesar 0,7 dari 15.635 wanita. Sebelum terjadinya kanker leher rahim akan didahului dengan keadaan yang disebut lesi prakanker. Prevalansi lesi prakanker leher rahim tahun 2012 sebesar 4,5%. Salah satu faktor resiko lesi prakanker leher rahim yaitu usia pertama kali berhubungan seksual < 17 tahun yang saat ini masih tinggi di masyarakat.Penelitian ini membahas hubungan usia pertama kali berhubungan seksual dengan kajadian lesi prakanker leher rahim pada wanita yang melakukan skrining dengan metode Inspeksi Visual Asam Asetat (IVA) di wilayah kerja Layanan Kesehatan Cuma-Cuma Dompet Dhuafa dengan sasaran penerima manfaat. Penelitian dilakukan dengan desain kasus kontrol dengan jumlah sampel 230 yang terdiri dari 46 kasus dan 184 kontrol. Analisis multivariat menggunakan regresi logistik.Hasil menunjukkkan bahwa usia pertama kali berhubungan seksual < 17 tahun meningkatkan resiko lesi prakanker leher rahim OR 4,092 (CI,1,769-9,464). Oleh karenanya peningkatan pengetahuan dan pemahaman tentang faktor resiko kanker leher rahim melalui edukasi, pendewasaan usia pernikahan serta deteksi dini melalui pemeriksaan rutin akan membantu mengurangi kasus lesi prakanker leher rahim.

---

Cervical cancer is second most common worldwide cancer afflict to women and leading cause of cancer deaths, particularly for women in developing countries (WHO, 2002). The prevalence of cervical cancer in women who has been screening in Jakarta around 1,2 from 5,919 and around 0.7 out of 15,635 in West Java. The diagnosis of cervical cancer will be preceded by a condition called pre-cancerous lesions. Prevalence of pre-cancerous cervical lesions in 2012 is 4.5%. One of the risk factors of pre-cancerous cervical lesions is age less than <17 years of first sexual intercourse which is still high in society.

This study explained relationship between first-time sexual intercourse with the occurrence of cervical pre-cancer lesions in female beneficiaries doing early detection using Visual Acetic Acid Inspection (IVA) at Layanan Kesehatan Cuma-Cuma Dompet Dhuafa. The study was conducted with case control design of 230 total sample consisting of 46 cases and 184 control. Multivariate analysis used logistic regression.

Results showed first age of intercourse less than <17 years increased risk of pre-cancerous cervical lesions OR 4,092 (CI, 1,769-9,464). According to this study increased knowledge and understanding of risk factors for cervical cancer through education, control of marriage age and early detection with periodically checkup will reduce cases of pre-cancerous cervical lesions."