USU MEDICAL STUDENTS’ KNOWLEDGE BATCH 2017 ABOUT RISK

FACTORS AND PREVENTION OF CERVICAL CANCER

Satria Nugraha Hsb1, Betty2

1
Student at Faculty of Medicine, Universitas Sumatera Utara Batch 2014
2
Lecturer of Anatomy Pathology Department, Faculty of Medicine, Universitas

Sumatera Utara

Email : satriahasibuan31@gmail.com
ABSTRACT
Cervical cancer is a primary cervical cancer originating from malignant
degeneration of epithelial metaplasia in the squamous columnar junction (SCJ), the
transition region of the vaginal mucosa and the cervical canal mucosa. Cervical cancer
is one of the most common cancers in women in the world with 471,000 new cases each
year. Cervical cancer is the second ranked in the type of cancer after breast cancer in
Indonesia.
The purpose of this research is to know how the description of the female student’s
knowledge in medical faculty of north sumatera university class of 2017 about the risk
factors and prevention of cervical cancer.
The type of this research is descriptive research with cross sectional design, and data
collection technique using questionnaire. The population of this study is all female
students in 2017 using total sampling technique.
Respondent's knowledge about cervical cancer risk factor mostly have enough
knowledge with 113 respondents (74,8%), and 31 (20,5%) have good knowledge, and 7
(4,6%) respondents have less knowledge. Respondent's knowledge about cervical
cancer prevention mostly have enough knowledge with 95 respondents (62,9%), and 49
(32,5%) have good knowledge, and 7 (4,6%) respondents have less knowledge.
From this study it was concluded that the knowledge level of the female students of
Medical Faculty of North Sumatera University class of 2017 about the risk factors and
prevention of cervical cancer in the enough category.
Keywords: cervical cancer, risk factors, prevention
INTRODUCTION

Cervical cancer is a primary cancer of the cervix originated from the malignant

degeneration of epithelial metaplasia in the area of squamous columnar joint (SSK),

which is the transition region of the vaginal mucosa and the cervical canal mucosa

(Andrijino, 2009).

Cervical cancer is one of the most common cancers in women in the world with

417,000 news cases each year. In developing countries, cervical cancer is ranked second

and reaches 300,000 deaths each year (Cervical cancer, 2007).

The risk factors that trigger the occurrence of cervical cancer include HPV

(Human Papilloma Virus) infection, smoking, HIV (Human Immunodeficiency Virus)

infection, diet, oral contraceptive use, parity, socioeconomic, and family history of

cervical cancer (ACS, 2013).

Cervical cancer is the second most type of cancer after breast cancer in Indonesia.

It is estimated that 40 to 45 cases of new cervical cancer occurs and 20 to 25 people

died every day (Yayasan Kanker Indonesia, 2013).

From data of Integrated Surveillance of Sentinel Hospital Based Disease in North

Sumatera in 2005, it was known that the proportion of inpatient cervical cancer patients

was 26.01% (58 cases) from 223 cases of cancer (Nasution, 2008).

The numerous cases concerning reproductive health, especially on sex behavior,

proves that the low knowledge on reproductive health is due to the fact that female

students have not became the target of adolescent reproductive health program, either

by the government or universities (Badan Koordinasi Keluarga Berencana Nasional,

2010).

METHOD
 The research type used was descriptive that aims to find out the overview of

female students of 2017 class of Faculty of Medicine, University of Sumatera Utara

against the risk factors & prevention of cervical cancer. The approach used was cross

sectional which all samples will be observed once and at one time.

The population of this research was all female students of 2017 class of Faculty of

Medicine, University of Sumatera Utara, Medan.

The research samples were all subjects taken from the research population by

using total sampling technique, in which the research samples of all female students of

2017 class of Faculty of Medicine, University of Sumatera Utara, Medan and fulfilled

the inclusion and exclusion criteria. The inclusion criteria of this research are: (1) All

female students of 2017 class of Faculty of Medicine, University of Sumatera Utara,

Medan; (2) Willing to become a research sample. The exclusion criteria of this research

are: (1) Not willing to become a research sample; (2) Not complete the questionnaire.

The data collected in this study were the primary data. The data obtained from the

questionnaire filling by respondents.

The processed data was analyzed descriptively by using computerization to find

out the overview of female students of 2017 class on the risk factors and prevention of

cervical cancer. The results of the data were presented in the form of narration and

frequency distribution tables or proportions.

RESULTS AND DISCUSSION

 Table 1. Frequency distribution of respondent’s knowledge on cervical cancer risk
factors
No Statement of Knowledge Right Wrong
(score 1) (score 0)
N % N %
1 Cervical cancer (cervix) is the abnormal growth of 146 96.7 5 3.3
cancer cells in cervix and the cells cancer are
transformed into malignancy
2 The trigger factors that initiate cervical cancer is 139 92.1 12 7.9
virus infection (Human Papilloma Virus/HPV)
3 Having sex or getting married at a young age 105 69.5 46 30.5
(before 20 years old) has nothing to do with the
occurrence of cervical cancer in women
4 The risk of cervical cancer increases when women 142 94 9 6
have multiple sexual partners
5 Having sex with men who have had sexual 121 80.1 30 19.9
intercourse with many women will not increase the
risk of cervical cancer
6 Having sex with an uncircumcised man may 92 60.9 59 39.1
increase the risk of cervical cancer
7 Women who often give birth is one of the risk 36 23.8 115 76.2
factors of cervical cancer
8 Smoking is not a risk factor for cervical cancer 92 60.9 59 39.1
9 Drug use can cause cervical cancer 73 48.3 78 51.7
10 Using immune suppressants for example after 44 29.1 107 70.9
receiving donor organs increases the risk of
cervical cancer
11 Lack of vitamin B9 intake (folic acid) can increase 88 58.3 63 41.7
the likelihood of cervical cancer in women

Based on the frequency distribution of respondents to cervical cancer risk factors

(Table 4.2.), the most statement answered correctly is statement number 1 of 146 people

(96.7%).

Most respondents also already know that too early sexual intercourse and have

multiple sexual partners are risk factors for cervical cancer, it can be seen from the

respondent's answer who answered correctly on the statement number 3 of 69.5% and

on the statement number 4 of 94%. Respondents gave more wrong answers on 3

statements only. Respondents did not know that women who often give birth is one of

the risk factors of cervical cancer (statement number 7).

Table 2. Frequency distribution of respondent’s knowledge on cervical cancer risk

factors
Knowledge Frequency Percentage (%)
Good 31 20.5
Enough 113 74.8
Poor 7 4.6

On respondents’ knowledge about cervical cancer risk factor (Table 4.3), mostly

have enough knowledge with 113 respondents (74,8%), and 31 people (20,5%) have

good knowledge, and only 7 people (4.6%) of these respondents had less knowledge

about cervical cancer risk factors.

This is in accordance with the research by Prakash Kanayasan (2011) on the level

of knowledge of female students of 2007 class of Faculty of Dentistry of University of

Sumatera Utara about the risk factor of cervical cancer, in which the majority of

respondents have enough knowledge, which is 66% (Kanayasan, 2011).

Tabel 3. Frequency Distribution of respondents’ knowledge on the prevention of

cervical cancer

No Statement of Knowledge Right Wrong

(score 1) (score 0)
N % N %
1 Avoiding cervical cancer risk factors is a precise 144 95.4 7 4.6
action in the prevention of cervical cancer
2 Delaying sexual activity until the age of 20 years is 89 58.9 62 41.1
not one of the prevention of cervical cancer
3 In order to avoid cervical cancer (cervical), should 139 92.1 12 7.9
not frequently changing couple
4 In order to avoid cervical cancer, should have many 138 91.4 13 8.6
children
5 Using condoms during intercourse can protect 107 70.9 44 29.1
themselves from cervical cancer virus
6 HPV virus vaccination is not as prevention of 115 76.2 36 23.8
 cervical cancer
7 Pap smear is one part of cervical cancer treatment 80 53 71 47
8 Pap smear is an early detection for cervical cancer 138 91.4 13 8.6
9 The purpose of pap smear examination is to maintain 30 19.9 121 80.1
the health of the feminine area of all venereal
diseases
10 A pap smear test is recommended every year for all 102 67.5 49 32.5
women who have had sexual intercourse
11 IVA (Visual Acid Inspection) is not an early detection 73 48.3 78 51.7
for cervical cancer

Based on the frequency distribution of respondents knowledge on the

prevention of cervical cancer (Table 4.4.), the most statement answered correctly is

statement number 1 as many 144 people (95,4%).

As many as 91.4% of respondents know that Pap smear examination is an early

detection of cervical cancer but it is not directly proportional to the statement of VIA

(Visual Inspection with Acid) examination as early detection of cervical cancer, because

as many as 51.7% of respondents do not know that VIA is an early detection of cervical

cancer. This proves that the rate of pap smear popularity is higher than the VIA

examination.

Table 4. Frequency Distribution of respondents’ knowledge on the prevention of

cervical cancer
Knowledge Frequency Percentage (%)
Good 49 32.5
Enough 95 62.9
Poor 7 4.6

Based on Table 4.5, it can be seen that the most respondents’ knowledge about the

prevention of cervical cancer are have enough knowledge with 95 respondents (62.9%),

and 49 people (32.5%) respondents have good knowledge, and only 7 people (4, 6%) of

these respondents have poor knowledge on the prevention of cervical cancer.

 In this data we find out that the level of knowledge of respondents, which are

female students of 2017 class of Faculty of Medicine, University of Sumatera Utara in

general can be said as enough knowledge. Therefore, in the future respondents need to

further improve their understanding on cervical cancer prevention so that in the future,

the prevalence of cervical cancer can be lowered.

This is consistent with the research by Kesavanraj A/L Konarsigaran (2015) on the

level of knowledge of female students of 2011 class of Faculty of Dentistry, University

of Sumatera Utara about the prevention of cervical cancer which the majority of them

have enough knowledge, that is 43.5% (Konarsigaran, 2015)

CONCLUSION AND SUGGESTION

Based on the description of the results and discussion can be concluded that: (1)

There are 30 respondents with a percentage of 20.5% have a good level of knowledge

about the risk factors of cervical cancer. While the majority of respondents, which are

113 respondents with the percentage of 74.8% have enough level of knowledge about

the risk factors of cervical cancer and only 7 respondents with a percentage of 4.6%

have poor knowledge about the risk factors of cervical cancer; (2) There are 49

respondents with a percentage of 32.5% have a good level of knowledge about the

prevention of cervical cancer. While the majority of respondents, which are 95

respondents with a percentage of 62.9% have enough level of knowledge about the

prevention of cervical cancer and only 7 respondents with a percentage of 4.6% have

poor knowledge about the prevention of cervical cancer; (3) From this research it can be

concluded that the level of knowledge of female students of class 2017 of the Faculty of
Medicine, University of Sumatera Utara on the risk factors and prevention of cervical

cancer in general are categorized as enough knowledge.

Suggestions for further researchers are: (1) Involve larger respondents and larger

areas in order to achieve more accurate results; (2) Conduct research to identify more

about factors that affect knowledge on risk factors and prevention of cervical cancer; (3)

Add variable to respondent's characteristic in order to add more and wider discussion.

Suggestions for the community are: (1) Add information about risk factors and

prevention of cervical cancer from various sources of information such as mass media

and other reading sources; (2) Ask directly to the doctor or health officer in accordance

to their field of experts and run healthy lifestyle behaviors such as eating foods with

balanced nutrition, not smoking, and avoid free sex.

Suggestions for health institutions are: (1) Provide more counseling to the wider

community, especially adolescent about risk factors and prevention of cervical cancer.

REFERENCES
ACS 2013, American Cancer Society, accessed 14 April 2014, Available at:
http://www.cancer.org/cancer/cervicalcancer
Andrijono. 2010, Kanker Serviks, Edisi 3, Balai Penerbit FK UI, Jakarta, pp. 1-9.
Badan Koordinasi Keluarga Berencana Nasional 2009, Mahasiswa Belum Banyak Tahu
Dampak Seks Pra Nikah, accessed 15 April 2017. Available at:
http://www.bkkbn.go.id/Webs/DetailRubrik.php?MyID=596
Cervical Cancer 2007, Cervical Cancer Statistic 2007, accessed 14 April 2017,
Available at: http://www.cervicalcancer.org/statistics.html
Konarsigaran A/L, K. 2015, Tingkat Pengetahuan Mahasiswi Fakultas Kedokteran Gigi
Angkatan 2011 Universitas Sumatera Utara Tentang Pencegahan Kanker Leher
Rahim, Universitas Sumatera Utara, Medan, accessed 3 november 2017, Available
from:
http://repository.usu.ac.id/handle/123456789/46367
Nasution, S.F. 2008, Karakteristik Penderita Kanker Serviks yang Dirawat Inap di
RSU. Dr. Pirngadi Medan Tahun 2003-2007, Universitas Sumatera Utara, Medan,
accessed 15 April 2017, Available from:
http://repository.usu.ac.id/handle/123456789/16494
Kanayasan, P. 2011, Tingkat Pengetahuan Mahasiswi Mengenai Faktor Resiko
Terjadinya Kanker Serviks di Fakultas Kedokteran Gigi USU Tahun 2003,
Universitas Sumatera Utara, Medan, accessed 3 November 2017, Available from:
http://repository.usu.ac.id/handle/123456789/21545
Yayasan Kanker Indonesia 2013, YKI Menyelenggarakan Training of Trainers Deteksi
Dini Kanker Leher Rahim Bekerjasama dengan SIKIB dan PERTAMINA,
accessed 15 April 2017, Available at:
http://yayasankankerindonesia.org/2013/training-of-trainers-nasional-deteksi dini-
kanker-leher-rahim/