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    Deteksi Dini CA Cerviks

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    wanda Achmad
    This document discusses cervical cancer, its causes, symptoms, risk factors, prevention, and screening. Some key points: - Cervical cancer is caused by certain strains of the human papillomavirus (HPV). HPV is spread through skin-to-skin contact, most commonly during vaginal, anal, or oral sex. - Screening methods like visual inspection with acetic acid (VIA) and Pap smears can detect abnormal or precancerous cells on the cervix. HPV DNA testing provides highly sensitive detection of HPV. - Early detection through regular screening is important, as it allows for early treatment before cancer develops. Lifestyle changes like safe sex practices and vaccination can help prevent

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Deteksi Dini CA Cerviks

    Uploaded by

    wanda Achmad
    39 views40 pages
    This document discusses cervical cancer, its causes, symptoms, risk factors, prevention, and screening. Some key points: - Cervical cancer is caused by certain strains of the human papillomavirus (HPV). HPV is spread through skin-to-skin contact, most commonly during vaginal, anal, or oral sex. - Screening methods like visual inspection with acetic acid (VIA) and Pap smears can detect abnormal or precancerous cells on the cervix. HPV DNA testing provides highly sensitive detection of HPV. - Early detection through regular screening is important, as it allows for early treatment before cancer develops. Lifestyle changes like safe sex practices and vaccination can help prevent

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    This document discusses cervical cancer, its causes, symptoms, risk factors, prevention, and screening. Some key points: - Cervical cancer is caused by certain strains of the human papillomavirus (HPV). HPV is spread through skin-to-skin contact, most commonly during vaginal, anal, or oral sex. - Screening methods like visual inspection with acetic acid (VIA) and Pap smears can detect abnormal or precancerous cells on the cervix. HPV DNA testing provides highly sensitive detection of HPV. - Early detection through regular screening is important, as it allows for early treatment before cancer develops. Lifestyle changes like safe sex practices and vaccination can help prevent

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    39 views40 pages

    Deteksi Dini CA Cerviks

    Uploaded by

    wanda Achmad
    This document discusses cervical cancer, its causes, symptoms, risk factors, prevention, and screening. Some key points: - Cervical cancer is caused by certain strains of the human papillomavirus (HPV). HPV is spread through skin-to-skin contact, most commonly during vaginal, anal, or oral sex. - Screening methods like visual inspection with acetic acid (VIA) and Pap smears can detect abnormal or precancerous cells on the cervix. HPV DNA testing provides highly sensitive detection of HPV. - Early detection through regular screening is important, as it allows for early treatment before cancer develops. Lifestyle changes like safe sex practices and vaccination can help prevent

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    Download as pptx, pdf, or txt
    of 40

    Anatomi Serviks

    TAMPILAN LEHER RAHIM

    N o rm a l Kanker Serviks
    “Kanker yang menduduki peringkat
    pertama dari keseluruhan kanker
    pada wanita”
    SETIAP THN, 14.000 WANITA
    DIDIAGNOSA KANKER SERVIKS DAN
    >7.000 DIANTARANYA MENINGGAL

    PADA 2020 DIPREDIKSI AKAN ADA


    LEBIH DARI 32.000 KASUS BARU
    DAN LEBIH DARI 12.000 KEMATIAN
    PER TAHUN AKIBAT KANKER
    SERVIKS

    SEBAGIAN BESAR KASUS


    DITEMUKAN PADA USIA PRODUKTIF
    HPV & KANKERSERVIKS

    • HPV penyebab Caserviks sejak1996


    • NIH Consensus Conference on Cervical Cancer,
    1996
    • World Health Organization/European Research
    Organization on Genital Infection and
    Neoplasia, 1996

    Reference: Munoz, N. et al. “HPV in the etiology of human cancer.” Vaccine 24S3 2006;24S3: 1-10.
    Kanker Serviks disebabkan oleh
    Human Papilloma Virus (HPV)

    Ada 13 Tipe HPV High risk menyebabkan kanker serviks:


    16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68
    1. Munoz N. et al. N Engl J Med 2003; 348:518-27
    What is human papillomavirus (HPV)?
    Human papillomavirus (HPV) is a virus that can be passed from person to
    person through skin-to-skin contact. More than 100 types of HPV have
    been found. About 30 of these types infect the genital areas of men and
    women and are spread from person to person through sexual contact.

    How common is HPV?


    HPV is a very common virus. Some research suggests that at least three
    out of four people who have sex will get a genital HPV infection at some
    time during their lives.

    The American College of Obstetricians and gynecologists


    How is HPV infection spread?

    HPV is primarily spread through vaginal, anal, or oral sex, but


    sexual intercourse is not required for infection to occur. HPV is spread
    by skin-to-skin contact. Sexual contact with an infected partner,
    regardless of the sex of the partner, is the most common way the virus is
    spread. Like many other sexually transmitted diseases, there often are
    no signs or symptoms of genital HPV infection.

    The American College of Obstetricians and gynecologists


    Human Papillomavirus

    Cancer of cervix 100%


    Cancer of anus 90%
    Cancer of vulva, vagina 40%

    Cancer of penis 40%


    Cancer of throat 12%
    Cancer of mouth 3%
    Cancer of esophagus .

    Cancer of skin .
    Cancer of X,Y,Z…. .
    13

    Parkin DM et al. CA Cancer J Clin 2005; 55:74-108.


    Cara Penularan
    • Infeksi dengan HPV seringkali TIDAK
    menimbulkan gejala

    • Banyak orang TIDAK tidak tahu mereka


    terinfeksi HPV

    • Banyak orang dapat menularkan HPV


    TANPA menyadarinya
    FAKTOR RISIKO

     Hubungan seksual pertama kali sebelum usia 20 tahun


     Multiple partner
     Riwayat STD
    BAGAIMANA TERJADINYA
    KANKER SERVIKS?
    Kanker serviks dapat berkembang ketika sel yang abnormal dalam
    serviks mulai membelah diri tanpa terkendali

    Sel yang abnormal pada serviks dapat berkumpul menjadi tumor

    Jinak
    • tidak berbahaya
    • tetap pada daerah sumbernya,
    TUMOR
    tidak menyebar

    Ganas
    • berbahaya , dapat menjadi
    kanker
    • akan menyebar ke
    daerah lain
    The Adam Health Illustrated Encyclopedia, A.D.A.M., Inc. is accredited by URAC,
    also known as the American Accreditation HealthCare Commission
    DETEKSI DINI DANSKRINING

     Inspeksi Visual Asam asetat (IVA) TEST


     Konvensional PAPSMEAR
     Liquid Base Cytology
     DETEKSI HPV
    VIA images

    Cervix with
    NORMAL CERVIX ACETO-WHITE lesion

    Source: EngenderHealth, Wright TC, 1996


    RUJUKAN
    PEMERIKSAAN IVA

    IVA POSITIF CURIGA KANKER

    RUJUK BIO PSI


    SpOG/K.Onk

    KRIO K .Onk POSITIF KANKER


    PAP SMEAR
    Pap Smear : pengambilan sel dari serviks, diperiksa dengan mikroskop
    untuk mengetahui adanya kelainan pada serviks

    JIKA ANDA SUDAH MENIKAH MELAKUKAN HUBUNGAN


    SEKSUAL, LAKUKAN PAP SMEAR SECARA TERATUR
    PAP TEST

    (-) ABNORMAL PAP TEST

    ROUTINE SCREENING
    HPV-DNA (3 YEARS)

    CERVICAL CANCER SCREENING


    ABNORMAL PAP TEST

    LSIL HSIL ASCUS AGUS

    REPEAT 3 MON THS HPV-DNA TEST


    FOLLOW UP HC-2
    COLPOSCOPY

    (+)

    CERVICAL CANCER SCREENING


    SITOLOGI
    Liquid Base Cytology

    www.thinprep.com
    KELEMAHAN SITOLOGI
    • Sensitivitas 40 %
    • Subyektifitas dan variabilitas tinggi
    • Ketepatan pengambilan spesimen, pembuatan preparat, serta
    keahlian dalam pembacaan hasil mempengaruhi sensitifitas dan
    spesifisitas hasil pemeriksaan
    • Rawan terjadi clumping, blood contamination, air bubbles,cells
    inadequate, & kurangpewarnaan
    • Kesulitan dalam pengiriman jarak jauh spesimen ke Lab PAkarena
    preparat rentan pecah
    • Keterbatasan jumlah dokter PAdi Indonesia
    DETEKSI HPV

    • Caserviks disebabkan H P V  menemukan virus H


    V
    P
    paling penting
    KENAPA LEBIH
    DIREKOM ENDASIKAN
    HPV DNA TEST

    HYBRID CAPTURE2

    GENOTYPING
    DETEKSI DINI
    • Visual Inspection with Acetic Acid
    (VIA)
    • Sensitivity between 30-70%
    • Specificity between 30-70%

    • Cytology
    • Sensitivity between 40-80%
    • Specificity between 90-98%

    • HPV testing
    • Sensitivity between 90 – 100%
    • Specificity between 92 – 96%
    ALGORITME
    DIAGNOSIS
    DAN TERAPI
    KANKER
    SERVIKS
    (WHO 2013)
    KORELASI HASIL DENGANKLINIS

    Hasil positif memiliki korelasi yang kuat dengan temuansel-sel


    abnormal pada serviks
    SERVIKS NORMAL
    (LEHER RAHIM)
    CERVICITIS
    LESI PRA KANKER
    STADIUM KLINIS
    KANKER SERVIKS

    Source: “FIGO Annual Report on The Results of Treatment in


    Gynaecological Cancer” Journal of Epidemiology and
    Biostatistics, (2001) vol. 6 no. 1, page 14.
    KANKER SERVIKS
    PENYAKIT HPV LAINNYA

     Kutil kelamin (genital


    warts)

     Sering kambuh

     Beban psikologis bagi


    penderitanya

     Tingkat kesembuhan
    bervariasi.4
    ..FAKTA..
     70 %pasien datang dalam stadium lanjut
     Skrening belum terorganisasi
     Wanita enggan melakukan pemeriksaan ginekologi
    dengan alasan takut ketahuan penyakitnya
     Faktor biaya untuk melakukan skrening

    Yayasan Kanker Indonesia, 2011


    …..Apa YangBisa Kita Lakukan….
     Pencegahan Primer :
    • Safe SEX
    • single partner,
    • hindari aktivitas seksual dibawah usia
    20 tahun
    • Gunakan barier

    • Vaksinasi
     Pencegahan sekunder : Skrining
    (DeteksiHPV)  rekomendasi WHO

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