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Cervical cancer is the most common cancer among women in the Indonesian population, yet little is known about the prevalence of human papillomavirus (HPV). We investigated age-specific prevalence of HPV types and possible risk factors of HPV positivity in a population-based sample of 2686 women, aged 15 -70 years, in Jakarta, Tasikmalaya, and Bali, Indonesia. The overall HPV prevalence was 11.4%, age-standardized to the world standard population 11.6%. The most prevalent types found were HPV 52, HPV 16, HPV 18, and HPV 39, respectively, 23.2, 18.0, 16.1, and 11.8% of the high-risk HPV types. In 20.7% of infections, multiple types were involved. Different age-specific prevalence patterns were seen: overall high in Jakarta, and in Tasikmalaya, and declining with age in Bali. The number of marriages was most associated with HPV positivity (OR 1.81 95% CI 1.31 -2.51)). Remarkably, in Indonesia HPV 16 and HPV 18 are equally common in the general population, as they are in cervical cancer. HPV 52 was the most prevalent type in the general population, suggesting that this type should be included when prophylactic HPV vaccination is introduced in Indonesia. Cervical cancer is the most common cancer in women in Indonesia, as in most developing countries (Tjindarbumi and Mangunkusumo, 2002;Parkin et al, 2005). From hospital-based data, it accounts for 28.6% of female cancers in Indonesia (Tjindarbumi and Mangunkusumo, 2002).Human papillomavirus (HPV) prevalence, age-specific prevalence, and type of distribution differ substantially between populations (Clifford et al, 2005;Franceschi et al, 2006) and HPV 18 has a greater role in cervical cancer in Indonesia than in the rest of the world. HPV 18 was found as frequently as HPV 16 in cervical cancer (Schellekens et al, 2004), or even more frequently than HPV 16 (Bosch et al, 1995). A small hospital-based case -control study conducted in Jakarta also found a high prevalence of HPV 18 in controls (de Boer et al, 2006). In view of the lack of population-based relevant data, we report here the age-specific prevalence data for HPV among women in Jakarta and Tasikmalaya on the island of Java and among women on the island of Bali, and assess possible risk factors in the aetiology of cervical cancer. MATERIAL AND METHODSThis population-based study was conducted as part of a screening project for cervical cancer in Jakarta and Tasikmalaya on the island of Java and different regions on the island of Bali in Indonesia between October 2004 and February 2006. Women were excluded if they were virgin, pregnant, had undergone a hysterectomy, or had previous cervical cancer. During our study it appeared that only married, divorced or widowed women participated in screening. Women who had never been married would strictly still be virgins because sexual intercourse before marriage is not allowed following Indonesia's cultural and religious rules.To reach women, in each region a collaboration was set up with the Pembinaan Kesejahteraan Keluarga (PKK), the national Indonesian Family Welfare Or...

ObjectiveThe purpose of this study was to describe the implementation of single visit approach or See-visual inspection of the cervix with acetic acid (VIA)-and Treat-immediate cryotherapy in the VIA positive cases-model for the cervical cancer prevention in Jakarta, Indonesia.MethodsAn observational study in community setting for See and Treat program was conducted in Jakarta from 2007 until 2010. The program used a proactive and coordinative with VIA and cryotherapy (Proactive-VO) model with comprehensive approach that consists of five pillars 1) area preparation, 2) training, 3) awareness, 4) VIA and cryotherapy, and 5) referral.ResultsThere were 2,216 people trained, consist of 641 general practitioners, 678 midwives, 610 public health cadres and 287 key people from the society. They were trained for five days followed by refreshing and evaluation program to ensure the quality of the test providers. In total, 22,989 women had been screened. The VIA test-positive rate was 4.21% (970/22,989). In this positive group, immediate cryotherapy was performed in 654 women (67.4%).ConclusionSee and Treat program was successfully implemented in Jakarta area. The Proactive-VO model is a promising way to screen and treat precancerous lesions in low resource setting.