HUBUNGAN PARITAS DENGAN JENIS HISTOPATOLOGI KARSINOMA SERVIKS UTERI DI RSUP Dr. SARDJITO YOGYAKARTA

Anyta Rahmawati, Prof. dr. Djaswadi Dasuki, SpOG (K), PhD

2012 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar Belakang:. Insiden kanker serviks 85% terjadi di negara berkembang. Jumlah penderita kanker serviks di RSUP Dr. Sardjito mengalami peningkatan setiap tahun. Jenis histopatologi dianggap sebagai salah satu faktor prognosis kanker serviks. Prognosis adenokarsinoma serviks lebih buruk dibandingkan karsinoma sel skuamosa. Adenokarsinoma serviks ditemukan lebih sedikit dibandingkan karsinoma sel skuamosa, tetapi insidennya cenderung meningkat. Faktor risiko yang berpotensi meningkatkan prevalensi adenokarsinoma serviks adalah nuliparitas dan obesitas. Tujuan: Penelitian ini bertujuan untuk memperoleh bukti hubungan antara paritas dengan jenis histopatologi karsinoma serviks. Metode:Rancangan penelitian menggunakan studi kasus-kontrol pendekatan kuantitatif. Subyek penelitian adalah pasien karsinoma serviks RSUP Dr. Sardjito yang terdaftar dari tanggal 1 Januari 2007 sampai 31 Desember 2008. Teknik pengambilan sampel dilakukan dengan non probability sampling jenis purpossive sampling. Data yang digunakan adalah data sekunder rekam medis pasien kanker serviks. Pengambilan data menggunakan check list. Analisis data melalui tiga tahapan, yaitu analisis univariabel, bivariabel menggunakan chi-square dan multivariabel menggunakan logistic regression. Hasil: Hasil analisis menunjukkan hubungan yang bermakna antara paritas dengan jenis histopatologi karsinoma serviks (OR:2,48; 95%CI: 1,06-6,07). Pada paritas 0-4 lebih berisiko terjadinya adenokarsinoma serviks, sedangkan paritas lebih dari empat berisiko terjadi karsinoma sel skuamosa. Umur, tingkat pendidikan, umur pertama kali menikah dan Indeks Massa Tubuh tidak berhubungan dengan jenis karsinoma serviks. Kesimpulan: Paritas dengan cutoff point empat berhubungan dengan jenis histopatologi karsinoma serviks.

Background: Eighty-five percents of the incidence of cervical cancer occur in developing countries. The number of patients with cervical cancer in Dr. Sardjito General Hospital has increased every year. Histopathological types are considered as one of the prognostic factors of cervical cancer. The prognosis of cervical adenocarcinoma is worse than squamous cell carcinoma. Cervical adenocarcinoma is found to be less than the squamous cell carcinoma, but the incidence tends to increase. Risk factors that could potentially increase the prevalence of cervical adenocarcinoma are nuliparity and obesity. Objective: To obtain evidence of a relationship between parity and histopathological types of cervical carcinoma. Methods: The study design used case-control study of quantitative approach. The subjects were cervical carcinoma patients at Dr. Sardjito General Hospital, registered from 1 January 2006 to 31 December 2007. The sampling technique was done by non probability sampling with a type of purposive sampling. The data used secondary data of the medical records of patients with cervical cancer. The data collection used checklists. The analysis of data was through three stages, namely univariable analysis, bivariable analysis using chi-square and multivariable analysis using logistic regression. Results: The analysis showed a significant relationship between parity and histopathological types of cervical carcinoma (OR: 2.48, 95% CI: 1.06 to 6.07). Parity of 0-4 was at higher risk of cervical adenocarcinoma, while the parity of more than four was at risk of squamous cell carcinoma. Age, education level, age at first marriage and Body Mass Index were not related to the types of cervical carcinoma. Conclusions: Parity with the cutoff point of four was associated with histopathological types of cervical carcinoma.

Kata Kunci : Kanker serviks, jenis histopatologi, paritas