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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...

These findings suggest that fat intake might be an important determinant of breast cancer among populations with a low fat diet in Indonesia.

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.

Background:We performed a cross-sectional study in Indonesia to evaluate the performance of a single-visit approach of cervical cancer screening, using visual inspection with acetic acid (VIA), histology and cryotherapy in low-resource settings.Methods:Women having limited access to health-care facilities were screened by trained doctors using VIA. If the test was positive, biopsies were taken and when eligible, women were directly treated with cryotherapy. Follow-up was performed with VIA and cytology after 6 months. When cervical cancer was suspected or diagnosed, women were referred. The positivity rate, positive predictive value (PPV) and approximate specificity of the VIA test were calculated. The detection rate for cervical lesions was given.Results:Screening results were completed in 22 040 women, of whom 92.7% had never been screened. Visual inspection with acetic acid was positive in 4.4%. The PPV of VIA to detect CIN I or greater and CIN II or greater was 58.7% and 29.7%, respectively. The approximate specificity was 98.1%, and the detection rate for CIN I or greater was 2.6%.Conclusion:The single-visit approach cervical cancer screening performed well, showing See and Treat is a promising way to reduce cervical cancer in Indonesia.

Introduction. Obesity becomes one of concern for surgeon as it provides additional morbidity in breast cancer. It influences the healing process negatively, and increase the complications following mastectomy. The most often found complication is seroma. Its incidence in obese is found higher than non-obese patient. Studies evaluating the correlation between obesity and seroma showed controversy. Hence, we run a study aimed to find out such a correlation in our characteristics. Method. We conducted cross sectional study. All patients treated with modified radical mastectomy (MRM) during period of 2013 to 2014 were included. Subject characteristics were recorded, including age, body mass index (BMI). Bilateral breast malignancy, diabetes mellitus and hypertension were excluded. Drain production and infection, and length of stay was recorded. Kolmogorov Smirnov test is used to find out normal distribution. In normal distribution, Pearson test or Spearman's is used to find out correlation. Results. Out of 72 samples underwent MRM and drainage, there were 67 enrolled. The mean age was found of 48.5±8.5 years, and mean BMI of 25.43 kg/m 2 ± 4.08. Length of stay ranged of 3-8 days and mean total seroma production was found of 502.3 mL ± 207.8. We found moderate positive linear correlation between obesity and seroma (r = 0.581; p <0.01; r2 = 0.338) rolled of 33.8% and strong positive linear correlation between seroma and length of stay (r = 0.581; p <0.01; r2 = 0.542) rolled of 52.4%. Conclusion. We found positive linear correlation between seroma and obesity, and positive linear correlation between seroma and length of stay.

AbstrakLlntuk menetapkan falaor-faktor risiko pada perkembangan kanker payudara d.ilakukan penelitian epidemiologik selama 3iahun yang termasuk pada penelitian kerjasama antara Indonesia dan Jepang. Metoda kasus-kontrol dipilih dan digunakan penderita yang mengunjungi Rumah Sakit Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Tiga In women, breast cancer ranked the second after cervical cancer,2'3 with relative frequency around lSEo in pathology based and limited population based cancer registry.

Penelitian cara kasus-kontrol telah dilakukan untuk analisafaktor risiko pada kanker payudara wanita Indonesia. Tiga ratus kasus dan 600 kontrol diwawancara menggunakan kuesioner baku untuk pengumpulan data epidemiologik. Subyek diteliti untuk berbagai data demografik, status reproduksi, perilaku seks, kebiasaan makan dan cara-cara hidup lain. Data dianalisa untuk menentukan faktor risiko yang bermakna menggunakan analisa univariat dan multivariat. Perhatian khusus diberikan untuk evaluasi faktor risiko berkaitan dengan golongan etnik yang berbeda. Suku Sunda, yang dikenal berbeda dengan suku-suku lain dalam hal kebiasaan makan dan cara hidup yang lebih tradisional, dibandingkan dangan suku-sulw non-Sunda. Hasilnya menampakkan bahwa faktor-faktor risiko berikut: ting kat sosial ekonomi dan pendidikan, tempat tinggal (pedesaan versus perkotaan), status perkawinan dan pekerjaan tidak bermakna, sedangkan di antara suku non-Sunda, menstruasi yang tidak teratur dan trauma payudara meningkatkan risiko, dengan OR dan C/95% masing-masing