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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 2  |  Page : 114-116

Education to increase early detection and myths about cancer among population in sub-district Medan Selayang Indonesia


1 Department of Biochemistry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Sumut, Indonesia
2 Department of Physiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Sumut, Indonesia

Date of Submission03-Apr-2019
Date of Decision16-May-2019
Date of Acceptance09-Jul-2019
Date of Web Publication19-Dec-2019

Correspondence Address:
Sry Suryani Wdjaja
Dr. Mansur No. 5, Medan, Sumut
Indonesia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCFM.IJCFM_32_19

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  Abstract 

Introduction: Cancer is estimated to affect about 14 million new cases globally each year. In Indonesia, the incidence is estimated at about 347,000 new cases each year. Most cancer patients seek medical advice only at advanced stage due to ignorance and lack of knowledge.
Aims: This is a community service study with the aim to conduct the training of tutor (TOT) of social health-care workers about awareness, early detection, and myths of cancer in subdistrict Medan Selayang, Indonesia.
Settings and Design: This is a community service study.
Material and Methods: Two hundred and five social health-care workers were trained on “Early Detection and myths about cancer” covering six sessions in six rural areas. A competition was held after 1 month of training.
Statistical Analysis Used: t-test was used to perform the statistical analysis.
Results: There was a statistically significant increase (P = 0.03) in Inspeksi visual asam asetat (IVA) participants (n = 95) in 2018 compared to 2017 (n = 26). Most of the 2017 participants were around 30 years and 45 years old (65%) and were not well educated (63%). The myths of cancer among the participants was assessed as good (20%), average (30%), and below expectation (50%).
Conclusion: TOT of social health-care workers shows a good response on educating people about early detection and myths of cancer. Social health-care providers play an important role in improving community health care.

Keywords: Cancer, early detection, education, myths


How to cite this article:
Wdjaja SS, Rusdiana, Savira M. Education to increase early detection and myths about cancer among population in sub-district Medan Selayang Indonesia. Indian J Community Fam Med 2019;5:114-6

How to cite this URL:
Wdjaja SS, Rusdiana, Savira M. Education to increase early detection and myths about cancer among population in sub-district Medan Selayang Indonesia. Indian J Community Fam Med [serial online] 2019 [cited 2020 Jan 24];5:114-6. Available from: http://www.ijcfm.org/text.asp?2019/5/2/114/273519


  Introduction Top


Cancer is estimated to affect about 14 million new cases globally each year. In Indonesia, the incidence is estimated at about 347,000 new cases each year, with an estimated increase by 70% within the next two decades. Charge for cancer treatment is around 895 billion US dollars/year. Mortality due to cancer is high and is reported to occur in about 1 in 6 deaths.[1],[2]

In Indonesia, most cancer patients seek medical advice only at advanced stage, making treatment difficult. This is mainly due to ignorance and fear about the disease. The myths about cancer with the use of alternative treatment methods will reduce life expectancy and quality of life and increase mortality.[3],[4] In the era before the social health insurance which was introduced by the Indonesian government, cancer patients were unable to seek proper treatment due to financial issues. With the introduction of social health insurance, now all citizens are covered by this scheme. However, due to ignorance and delay made in seeking treatment, cancer treatment in these patients is impossible. The mortality and morbidity are still high because most of the patients present with late-stage cancer. The early detection of cancer has been the main target of the Indonesian health-care system and world cancer control programme. Education that covers the entire community will be in the right direction.

Medan is the third largest city in Indonesia and is one of the subdistricts called Medan Selayang which has 41 Posyandus (integrated health-care community centers) that provide community health care and counseling. There are 41 Posyandus in this subdistrict with 205 social health-care workers from six rural areas, namely, Padang Bulan (PB) Selayang I, PB Seayang II, Tanjung Sari, Asam Kumbang, Beringin, and Sempakata, which serve a total population of around 119,831 within 9.01 km2 and easily accessible by public transport.[5] Medan Selayang subdistrict has the right objective to educate social health-care workers on early detection and myths about cancer. This education will serve the community and training of tutors (TOTs) in social health workers on early detection and myths about cancer in Medan Selayang.


  Material and Methods Top


Two hundred and five social health-care workers were trained on “Early Detection and Myths about Cancer” covering six sessions in six rural areas. The session also covers the bi-monthly routine examination for “Inspeksi visual asam asetat (IVA)” or “visual inspection with acetic acid” in the year 2018. Age and education status are recorded, and knowledge about the myths of cancer is determined after the training which comprises:

Education in three phases:

  1. Prior knowledge (given earlier about early detection and myths about cancer)
  2. Early detection of breast and cervical cancers


    • Early detection method in self-examination of breast cancer and the importance of routine Papanicolaou stain smear.
    • Extension training
    • Conduct self-breast examination and counseling under the guidance of the tutors
    • Audio–visual screening on cancer, booklets, and posters for all posyandus.


Program evaluation and sustainability

After the program, the social health-care workers are expected to play an active role in educating the people, thus enabling to find an increase in early-stage cancer by bringing the suspected early-stage cancer patient to the primary health-care centers or the hospital which will support the general health program.

Evaluation on the success of education was determined from the increasing number of IVA participants at the free IVA examination at PB Selayang II, Health Centre PB, Medan Indonesia. A competition was held after 1 month of training to find the social health-care worker who succeeded in bringing the highest number of IVA participants and the ability to do community counseling on early detection and myths about cancer.


  Results Top


Medan Selayang is a subdistrict of 9.01 km2 comprising six rural areas with a total population of around 119,831. There was a statistically significant increase (P = 0.03) in IVA participants (n = 95) in 2018 compared to 2017 (n = 26). Most of the 2017 participants were around 30 years and 45 years old (65%) and were not well educated (63%). The myths of cancer among the participants was assessed as good (20%), average (30%), and below expectation (50%).

The illustrations of IVA participants based on gender and rural areas are shown in [Table 1] and [Table 2], respectively.
Table 1: Population according to gender and rural areas

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Table 2: Total Inspeksi visual asam asetat's participants

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  Discussion Top


The knowledge on cancer in this education program showed that social health-care workers had minimal knowledge about cancer before training. Awareness on the importance of early detection of cancer is still below expectation, especially in the community. The haunting myths on fears and shame to hide the disease are the main causes for patients to rely heavily on alternative medicine.

From the first TOTs in Medan sub-district competition, there was a significant increase in the number of IVA participants and showed that most of them are not well educated. This suggests the need for more public talks, which should be the priority of the health department. The increasing number of participants suggests increased awareness of early cancer detection and dispels the myths, and TOT can be a good method which should be encouraged. The issues on early cancer detection and myth awareness should be spread especially in the rural communities.


  Conclusion Top


Education and community health counseling awareness are important in the rural areas. TOTs showed a good response in educating people about early cancer detection and their myths. This should be sustained and followed up. Social health-care providers play an important role in improving community health care.

Acknowledgment

This is to acknowledge that the community service study was supported by the Ministry of Research and Technology and Higher Education Republic Indonesia under grant DRPM.

Financial support and sponsorship

This study was financially supported by the Ministry of Research and Technology and Higher Education Republic Indonesia under grant DRPM.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Globocan Web Portal for International Cancer Research; 2012. Available from: http://publications.iarc.fr/Databases/Iarc-Cancerbases/GLOBOCAN-2012-Estimated-Cancer-Incidence-Mortality-And-Prevalence-Worldwide-In-2012-V1.0-2012.[Last accessed on 2019 Mar].  Back to cited text no. 1
    
2.
Indonesia Basic Health Research; 2013. Available from: http://ghdx.healthdata.org/record/indonesia-basic-health-research-2013..[Last accessed on 2019 Mar].  Back to cited text no. 2
    
3.
Jayalie VF, William A, Shelly, Irawan Cl. The role of metformin as an inhibitor insulin-like growth factor-1 receptor (IGF-1R), Epidermal Growth Factor Receptor (EGFR) and mammalian target of rapamycin (mTOR) pathways in lung cancer treatment. Cdk 2016;43:416-20.  Back to cited text no. 3
    
4.
Amin Z, Jayalie VF, Rajabto W. Recent management of patients with advanced epidermal growth factor receptor mutation non-small cell lung cancer: Role of afatinib and lesson learned for developing countries. Acta Med Indones 2017;49:79-88.  Back to cited text no. 4
    
5.
Selayang Medan Demographics. National Statistics Agency; 2018. Available from: https://medankota.bps.go.id/publication/2017/ 09/18/f3a43e81814e837ac78ae5ab/kecamatan-medan-selayang-dalam-angka-2017.html. [Last accessed on 2019 Mar].  Back to cited text no. 5
    



 
 
    Tables

  [Table 1], [Table 2]



 

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Introduction
Material and Methods
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