According to the World Health Organization (WHO), this illness remains a silent killer, claiming more than 340,000 women’s lives annually. Alarmingly, around 90 percent of these deaths occur in developing nations.
In Indonesia, the picture is equally murky. The 2022 Globocan report by WHO’s International Agency for Research on Cancer revealed that the country recorded around 36,964 new cases, with more than 20,000 women losing their lives to the disease annually.
The tragedy lies in the fact that cervical cancer is widely regarded as one of the most preventable and curable forms of cancer—provided it is detected early.
Dr. Siti Nadia Tarmizi, Director of Non-Communicable Diseases at Indonesia’s Ministry of Health, stressed that cervical cancer is relatively easier to eliminate through early detection and intervention among sexually active women aged 30 to 59.
“Screening for early detection is essential to prevent cancer from progressing to more advanced stages. The odds of survival are far higher when a case is detected and treated early,” she told ANTARA through a short message.
Still, the lack of awareness about the urgency of early detection has left many patients rushing to hospitals only after their cervical cancer has reached an alarming stage.
This trend, according to Dr. Lisa Puspadewi Susanto, an obstetrician and gynecologist at EMC Alam Sutera Hospital, is largely rooted in ignorance or negligence among women regarding the importance of early screening through Visual Inspection with Acetic Acid (VIA) or Pap smear tests.
“Many women hesitate to undergo cervical cancer screening, often avoiding hospital visits unless they feel ill,” she said.
She noted that, as a vast archipelagic country, Indonesia still struggles to provide equitable access to health services for all citizens. The disparity is clear: while women on Java Island benefit from relatively higher rates of early cervical cancer detection, those in regions with limited medical facilities face lower screening rates.
“In short, suboptimal human resources and geographical constraints have left our archipelagic state struggling with an uneven distribution of specialist doctors, as well as diagnostic and therapeutic equipment,” Susanto added.
Added to those shortcomings are the heightened risks of Human Papillomavirus (HPV) among Indonesia’s youth. The doctor observed that a shift in sexual behavior among youngsters has prompted stakeholders to intensify preventive and educational efforts.
“We can see more teenagers today becoming sexually active at an early age, and to make matters worse, they tend to change partners. This trend adds yet another crucial layer to cervical cancer risks,” said the obstetrician, whose youngest patient battling cervical cancer was just 19 years old.
However, she underscored that it typically takes 15 to 20 years for an HPV infection to progress into cervical cancer. This long time frame should provide an opportunity for many to detect and treat the disease before it’s too late.
The problem, she continued, is that many women tend to overlook their condition, downplaying symptoms that often seem ordinary. Among the most common warning signs of cervical cancer are brownish or pinkish vaginal discharge with an unusually foul odor and heavy volume, menstrual periods lasting longer than eight days, and excessive bleeding that forces women to change sanitary napkins more than four times a day.
Susanto also pointed to post-intercourse bleeding and hip pain during or after sex as danger signs. Anemia and persistent bowel or urinary problems, she warned, often signal cervical cancer in its most dangerous stage.
All things considered, the specialist urged women experiencing persistent, heavy, or unusually early menstruation to immediately undergo screening—starting with IVA tests and followed by Pap smears for greater accuracy.
She also recommended HPV DNA testing for those with positive IVA results, as it can detect the virus even before cellular changes occur.
Taking notice of the heightened risks of HPV among youngsters, the Ministry of Health has set a target of vaccinating at least 90 percent of boys and girls against the virus before the age of 15 by 2030, as announced by Director of Immunization Prima Yosephine.
Returning to Dr. Tarmizi, head of the ministry’s non-communicable disease department, the doctor assured the public that the government is rolling out various initiatives to bring cervical cancer care closer to women across Indonesia. She cited ongoing efforts to promote a system of technical and clinical mentoring from referral hospitals to local health facilities at the district and city levels.
“Given the evident shortage of health workers, we hope this mentoring scheme will enable cervical cancer patients in districts and cities to access adequate treatment,” she said.
The official further reiterated the urgency of early detection, noting that it saves lives and spares families the crushing costs of advanced treatment.
“Treating this disease early requires far lower costs, as it does not necessarily involve invasive procedures. This approach also eliminates the need for patients to be referred to provincial or central hospitals, since they can undergo treatment at local general hospitals,” Tarmizi concluded.
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Translator: Nabila Anisya, Tegar Nurfitra
Editor: Azis Kurmala
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