Jakarta, August 19th 2023. Prof. Dr. dr. Junita Indarti, Sp.OG(K) was inaugurated as Professor of Obstetrics and Gynecology, Faculty of Medicine (FK), Universitas Indonesia (UI), after delivering her scientific oration entitled “The Scientific Role of Social Obstetrics and Gynecology on Cervical Cancer Screening Coverage in Era of Health Transformation in Indonesia”. The inauguration procession, which was held on Saturday (19/8) in the IMERI-FKUI Building, Salemba Campus was led directly by the Rector of UI, Prof. Ari Kuncoro, S.E., M.A., Ph.D.
In her inaugural speech, Prof. Junita conveyed the important role of social obstetrics and gynecology science in efforts to reduce the number of cervical cancer patients in Indonesia. According to data from the 2021 Indonesia Health Profile, cervical cancer ranked second after breast cancer, with 36,633 cases or 17.2% of all cancers in women. This number has a high mortality rate of 21,003 deaths or 19.1% of all cancer deaths. When compared to the incidence of cervical cancer in Indonesia in 2008, there was a two-fold increase.
The high incidence of cervical cancer in Indonesia is influenced by the low screening coverage. Until 2021, only 6.83% of women aged 30–50 years will undergo screening tests using the IVA method. In 2023, cervical cancer screening coverage in Indonesia will only reach 7.02% of the target of 70%. If not treated effectively, cervical cancer rates will increase and cause a large socio-economic burden and decrease the quality of life of individuals.
In the midst of these challenges, Indonesia’s efforts to accelerate cervical cancer prevention are related to the five pillars of health system transformation which include transformation of primary services, referral services, health financing systems, health human resources (HR), and health technology. These five pillars can support two cervical cancer prevention strategies, namely primary prevention through immunization by the Human Papillomavirus (HPV) vaccine and secondary prevention by early detection of cervical cancer.
Innovative screening methods and prevention approaches need to be developed to make them more effective, affordable, and accessible. Cervical cancer screening methods used in Indonesia are IVA, Pap Smear, and the HPV DNA test. Each method has its own advantages and disadvantages, so it is necessary to pay attention to which one is most suitable for implementation in Indonesia.
The IVA method is still the screening method of choice at an affordable cost compared to the HPV DNA test and Pap Smear. However, the obstacle is that apart from having to train health workers, a comprehensive referral follow-up flow must also be made for positive results. If it cannot be managed at the Health Facility level 1, the patient must be referred to a hospital with a clear referral path.
Another screening method is the HPV DNA test, which has been used in several developed countries because it is more effective in detecting precancerous lesions. The sensitivity of the HPV DNA test is very high, namely 80–98%. This examination can be carried out by untrained health workers or patients independently/self-sampling. Currently, research has been carried out to develop an examination of HPV DNA in urine. Examination with this urine sample can accommodate patients who have not been screened due to various inhibiting factors.
The implementation of HPV DNA testing in Indonesia is still constrained by high costs. However, after having a local HPV DNA examination made by the nation’s youth, the cost of the test, which was originally around 600-800 thousand rupiahs, could be reduced to 149,850 rupiah. This means that to meet the target of achieving 70% cervical cancer screening coverage by 2023, around 4 trillion rupiah is needed.
“Given that cervical cancer has a broad impact, stricter regulations are needed, which require women to check themselves regularly. The role of Social Obstetrics and Gynecology has great potential in supporting cervical cancer screening coverage, as well as mitigating the widespread impact through developing evidence-based strategies. Collaboration between the central and regional governments, hospitals, health centers, professional organizations, and the community is very important for the realization of better health and quality of life for Indonesian women,” said Prof. Junita.
Thanks to her research, Prof. Dr. dr. Junita Indarti, Sp.OG(K) was officially named a Professor of FKUI. Previously, she had also written several studies, including Maternal and Neonatal Outcomes in Pregnant Women with Chronic Energy Deficiency in Cipto Mangunkusumo General Hospital Indonesia (2023); Efficacy of Polycarbophil Moisturizing Gel in Women with Genitourinary Syndrome of Menopause: A Randomized Control Trial (2023); and Possible Different Genotypes for Human Papillomavirus Vaccination in Lower Middleincome Countries Towards Cervical Cancer Elimination in 2030: A Cross-Sectional Study (2022).
Prof. Dr. dr. Junita Indarti, Sp.OG(K) graduated from FKUI for the Medical Education Program (1983), Obstetrics and Gynecology Specialist Doctor Education Program (1993), and Doctoral Study Program for Doctor of Medicine (2009). In 2015, she completed her studies at the Social Obstetrics and Gynecology Consultant Program, Indonesian Obstetrics and Gynecology Collegium. Currently she serves as Head of the Integrated Inpatient Service Installation Building A and is active in the Special Board of the Indonesian Obstetrics and Gynecology Association Center (PP POGI).
