Cervical cancer in Indonesia in 2018 ranks second in cancer in women in Indonesia with an incidence rate of 348.809 cases with a mortality rate of nearly 60% of the incidence, namely 207.210 deaths. Deaths from cervical cancer are projected to continue to increase and are estimated to reach 12 million deaths by 2030 if not treated properly. The incidence of cervical cancer in Indonesia is estimated to have 180.000 new cases per year and the death rate is thought to reach 75% in the first year. This death is mainly associated with the majority of newly diagnosed patients who are already at an advanced stage (70% of cases) and are already at the terminal stage at the time of diagnosis.

Object: To assess the diagnostic value of Risk of Ovarian Malignancy Algorithm (ROMA) in predicting ovarian malignancy. Methods: Diagnostic test was performed at dr. Mohammad Hoesin Hospital Palembang during June 2016 to November 2016. Data were analized with SPSS version 21.0 and Med-calc statistic. Results: A total of 57 subjects were recruited in this study. Subjects were divided into two groups: the premenopausal and postmenopausal group. Analysis with ROC curve was performed, the ROMA optimal cut-off of ROMA was 23.7% and 48.15% in the premenopausal and the post-menopausal group, respectively. With the optimal cut-off, the sensitivity was 79.41% and specivicity was 75%, positive predictive value wa 73.07% and negative predictive value 83.77% with accuracy 76.92% in diagnosing ovarian malignancy. Compared to RMI-3, the sensitivity was 65.5% and specivicity was 85.7% with accuracy 75.44%. Conclusion: ROMA is not a reliable diagnostic tools of ovarian malignancy. Keywords: CA125, HE4, ovarian cancer, risk of ovarian malignancyalgorithm/ ROMA, risk of ovarian malignancy index/RMI

Abstract Objective: To determine the efficacy of Channa striata extract on serum albumin level and wound healing after radical hysterectomy in cervical cancer patients in Mohammad Hoesin Hospital Palembang.Methods: A clinical trial was conducted in Mohammad Hoesin Hospital Palembang during period of January – September 2019. Samples were cervical cancer patients undergoing radical hysterectomy. Serum albumin level was measured before surgery, after surgery, and after the administration of Channa striata extract capsule. Efficacy of the supplement was analyzed with SPSS version 20 using paired t-test.Result: Twenty-eight cervical cancer patients undergoing radical hysterectomy who fulfilled inclusion criteria were obtained. Majority of patients were aged between 40-49 years old (89.3%), normoweight (39.3%), and lived in rural area. Mean duration of surgery was 154.46 ± 40.47 minutes. Serum albumin level before surgery, after surgery and after the administration of Channa striatus extract were 3.4 ± 0.61 g/dL, 2.91 ± 0.42 g/dL, and 3.11 ± 0.49 g/dL, respectively. There was a statistically significant difference between serum albumin level before and after the surgery (p=0.000). However, no statistically significant difference was found between serum albumin level after surgery and after administration of Channa striata extract capsule (p=0.750).Conclusions: There was no significant difference between serum albumin level after surgery and after administration of Channa striata extract capsule.Keywords: cervical cancer , channa striatus extract , radical hysterectomy, serum albumin level. Abstrak Tujuan: Untuk mengetahui efikasi ekstrak Channa striata terhadap kadar albumin serum dan penyembuhan luka pasca histerektomi radikal pada pasien kanker serviks di RS Mohammad Hoesin Palembang.Metode: Uji klinis dilakukan di RS Mohammad Hoesin Palembang selama periode Januari – September 2019. Sampel adalah pasien kanker serviks yang menjalani histerektomi radikal. Kadar albumin serum diukur sebelum operasi, setelah operasi, dan setelah pemberian kapsul ekstrak Channa striata. Khasiat suplemen dianalisis dengan SPSS versi 20 menggunakan uji-t berpasangan.Hasil: Didapatkan 28 pasien kanker serviks yang menjalani histerektomi radikal yang memenuhi kriteria inklusi. Mayoritas pasien berusia antara 40-49 tahun (89,3%), normoweight (39,3%), dan tinggal di daerah pedesaan. Durasi rata-rata operasi adalah 154,46 ± 40,47 menit. Kadar albumin serum sebelum operasi, setelah operasi dan setelah pemberian ekstrak Channa striatus berturut-turut adalah 3,4 ± 0,61 g/dL, 2,91 ± 0,42 g/dL, dan 3,11 ± 0,49 g/dL. Ada perbedaan yang signifikan secara statistik antara kadar albumin serum sebelum dan sesudah operasi (p=0,000). Namun, tidak ditemukan perbedaan yang signifikan secara statistik antara kadar albumin serum setelah operasi dan setelah pemberian kapsul ekstrak Channa striata (p=0,750).Kesimpulan: Tidak terdapat perbedaan yang bermakna antara kadar albumin serum setelah pembedahan dan setelah pemberian kapsul ekstrak Channa striata.Kata kunci: ekstrak Channa striatus, histerektomi radikal, kadar albumin serum, kanker serviks.

HPV is a sexually transmitted virus, and high-risk HPV DNA was found in 99.7%of cervical cancer specimens. Within 12 to 24 months of exposure to the virus,90% of HPV infections disappear or become inactive. However, infection with high-risk strains of HPV persist which then increases the risk of progression to cervicalcancer. The detection of precancerous lesions consists of various methods,including pap smear (conventional or liquid-base cytology / LBC), visualinspection of acetic acid (IVA), visual inspection of lugoliodine (VILI), and HPV DNAtest (genotyping / hybrid capture).

WHO has created a global strategy to accelerate the elimination of cervical canceras a public health problem and a world burden. Cervical cancer is a disease thatcan be prevented and cured, as long as it is detected early and treated effectively.Cervical cancer is also a disease that reflects global injustice. The burden isgreatest in low- and middle-income countries, where access to public healthservices is limited and screening and treatment for the disease has not been widelyapplied. In 2018, nearly 90% of all deaths worldwide occurred in low and middleincome countries. Furthermore, the proportion of women with cervical cancer whodie from the disease is more than 60% in these countries, more than double thenumber in many high-income countries, which is only 30%.