KANKER Leher Rahim bisakah dicegah ??

mochamad maroef

RS Universitas Muhamadiyah Malang

28 Desember 2013

Organ Genitalia Perempuan

Leher rahim

Jumlah kasus baru : 40/hari Jumlah kematian : 20/hari

Kanker Cervix di Indonesia

Epidemiologi

Epidemiologi NA + Europe

Africa

Asia

Latin

36,000

62,000 33,000

143,000

75,000

79,000 72,000

266,000

Ferlay J et al. Globocan 2002. IARC 2004.

PEMBUNUH WANITA no. 1

PENYEBAB CA CERVIX

HPV Kanker Serviks disebabkan oleh HPV

Kanker Serviks bukan penyakit keturunan

HPV

HUMAN PAPILOMA VIRUS

HPV Kanker Serviks disebabkan oleh HPV Kanker Serviks bukan penyakit keturunan

Histolopathology: CIN1 CIN 1: Mild dysplasia; includes condyloma (anogenital warts)2 CIN 2: Moderate dysplasia2 CIN 3: Severe dysplasia; CIS; FIGO stage 02,3

Normal CIN 1 CIN 2 CIN 3

Basal cell layer

All figures reprinted with permission from Frappart, et al. Histopathology and Cytopathology of the Uterine Cervix. Digital Atlas, Lyon, France: IARC Press, 2004.

LESI CERVIX

Normal Cervix

HPV Infection / CIN* 1

CIN 2 / CIN 3 / Cervical Cancer

Natural History of Cervical Cancer

Mild Dysplasia

Moderate Dysplasia

Severe Dysplasia

Ca CA Insitu Invasive

Cancer

Pracancer Lesion Cancer

------------------ 3-17 year--------------

CIN I CIN II CIN III

HPV

Screening

Progression Normal

CIN I CIN II CIN III

Ca. Cervix Stage I - IV

>>>

>> >

99,7 % infeksi HPV

GAMBARAN PAP SMEAR Normal

GAMBARAN PAP SMEAR CIN

KANKER Serviks

GENITAL WARTS

Disebabkan HPV Type 6 dan 11

HPV Type 6 & 11 Penyebab > 90 % anogenital warts

Beban Psikologis Bagi Penderitanya.

Sering Kambuh

Presentation of Genital Warts: Penile

Gardasil is indicated for the prevention of high-grade cervical dysplasia (CIN 2/3), cervical carcinoma, high-grade vulvar dysplastic lesions (VIN 2/3), and external genital warts (condyloma acuminata) causally related to Human Papillomavirus (HPV) types 6, 11, 16 and 18. The indication is based on the demonstration of efficacy of Gardasil in adult females 16 to 26 years of age and on the demonstration of immunogenicity of Gardasil in 9- to 15-year old children and adolescents. Protective efficacy has not been evaluated in males. The use of Gardasil should be in accordance with official recommendations.

Presentation of Genital Warts: Vulvar

Reprinted with permission from NZ DermNet (www.dermnetnz.org)

Recurrent Respiratory Papillomatosis (RRP)

Age distribution is bimodal with peaks at1: 2 to 4 years of age (childhood-onset) 20 to 40 years of age (adult-onset)

Usually caused by HPV types 6 or 112 Papillomas are stratified squamous

epithelial masses that can obstruct the airway if not removed.2

Although histologically benign, RRP causes significant morbidity and mortality due to recurrent nature.2 Could require surgery under general anesthesia as

frequently as every few weeks Possible causative role of RRP in head and neck cancers2-4

RRP

PAPILOMAS

Setiap perempuan berisiko terkena

HPV penyebab kanker serviks dalam masa hidupnya

tanpa memandang usia dan gaya hidup

INSIDENSI

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PENULARAN HPV Setiap wanita yang aktif secara seksual beresiko

terkena HPV onkogenik

Infeksi HPV dapat ditularkan melalui sexual intercouse, skin-to-skin genital contact, manual to genital, oral to genital,

Penetrasi seksual tidak selalu diperlukan untuk terjadinya infeksi

Penggunaan kondom dapat mengurangi resiko infeksi, namun tidak memberikan proteksi penuh dari infeksi HPV

Ibu dapat menularkan HPV pada bayi baru lahir saat proses persalinan transmisi vertikal

Beberapa faktor mempermudah infeksi HPV

Usia muda (puncak infeksi usia 2029 )1 Berganti pasangan2 Memulai hubungan di usia muda*,3 Merokok*,4 dll

Kebanyakan infeksi HPV

berlangsung tanpa gejala

PENCEGAHAN DETEKSI DINI PENGOBATAN

EDUKASI KONDOM VAKSINASI

PAP SMEAR VIA

Penanganan Kanker Serviks

Kemoterapi Radioterapi Pembedahan

atau Konsultasi kepada dokter anda

VIRUS BAKTERI

Penyakit Menular

Manfaat Vaksinasi

Vaksin HPV Vaksin HPV tipe 6, 11, 16 & 18

berpotensi mencegah lebih dari 70% kasus kanker serviks dan 90% kasus Genital Warts

Vaksin HPV ditujukan untuk perempuan usia 10 55 (panduan HOGI)

Jadwal pemberian: 3 dosis (bulan ke-0, ke-2 dan ke-6)

Penting untuk di-INGAT!!!

Kanker serviks adalah kanker yang banyak menyebabkan kematian pada perempuan

Kanker serviks dapat dicegah : Deteksi sedini mungkin Edukasi mengenai kanker serviks Vaksinasi HPV VAKSIN

KONSULTASIKAN KEPADA DOKTER ANDA TENTANG KANKER SERVIKS & CARA PENCEGAHANNYA