Upaya Pencegahan Kanker Serviks melalui Vaksinasi dan Skrining Human Papillomavirus
Abstract
Kanker serviks masih menjadi salah satu penyebab kesakitan dan kematian tertinggi pada perempuan secara global akibat keganasan. Infeksi human papillomavirus (HPV) risiko tinggi (high-risk HPV/ hrHPV) terutama HPV 16 dan 18 merupakan penyebab etiologis terjadinya kanker serviks. Pemanfaatan vaksin HPV baik bivalen, quadrivalen, dan generasi terbaru 9-valen dinilai efektif untuk mencegah terjadinya kanker serviks di negara-negara maju, sementara di negara-negara berkembang masih terkendala dengan sumber daya yang terbatas. Disamping vaksinasi, skrining kanker serviks masih penting untuk dilakukan untuk preventif. Deteksi dini secara sitologis menggunakan Pap smear merupakan metode konvensional dengan sensitifitas dan spesifisitas yang tinggi, namun sulit diterapkan di negara-negara berkembang. Inspeksi visual asam asetat (tes IVA) menjadi alternatif pemeriksaan sitologis yang lebih murah, namun akurasinya untuk identifikasi lesi prakanker masih diperdebatkan. Tes DNA HPV saat ini menjadi pilihan pencegahan kanker serviks terbaru yang uji sensitiftas dan spesifisitasnya mampu menyamai Pap smear pada kasus neoplasia intraepitelial serviks (CIN) +2 dan +3. Jadwal skrining yang lebih sedikit dan adanya peluang untuk melakukan pengambilan sampel secara mandiri membuat tes HPV sangat ideal untuk dimasukkan pada program pencegahan primer pada negara berkembang. Tinjauan ini bertujuan untuk memaparkan kondisi terbaru mengenai epidemiologi kanker serviks dan upaya preventif terkini yang lebih efektif.
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