EARLY DETECTION OF CERVICAL CANCER AND PAP SMEAR ADEQUACY AT PUSKESMAS PILANGKENCEN, MADIUN DISTRICT

This study aims to increase understanding about early detection of cervical cancer and pap smear evaluation among residents, as well as to increase the pap smear sampling skills by health workers in Pilangkenceng District, Madiun Regency. This study was a descriptive observational study using a cross-sectional approach which was conducted on 100 women, from the Pilangkenceng Primary Health Center in Madiun Regency, aged 20 to 70 years. Pretest and post test assessments were carried out before and after the education of cervical cancer. Specimen adequacy assessment was carried out on 100 Pap smear samples taken by the health workers based on the Papaniculaou classification and the Bethesda system. Pap smear results were also compared with the results of the visual inspection of acetic acid (IVA) which was done before. Education of cervical cancer to the community can increase people's understanding of cervical cancer by 8.05% to 82.26%, while training for health workers on the technique of pap smear sampling shows an increase in knowledge of 51.62% to 100%. Adequacy of pap smear samples by health workers in Pilangkenceng District, Madiun Regency showed that 99% were adequate and satisfactory. Ten percent of IVA examinations showed positive results and those cases showed signs of inflammation and infection on pap smear examination. Community service activities of early detection of cervical cancer through the pap smear method can increase the understanding of early detection of cervical cancer in the community and the knowledge and sampling skills of health workers, hence the health workers at the Pilangkenceng Primary Health Center are ready to provide pap smear services for the community.   Keywords: adequacy, early detection, pap smear, IVA, cervical cancer.   Abstrak Kegiatan ini bertujuan untuk mengetahui peningkatan pemahaman tentang deteksi dini kanker serviks dan serta evaluasi pap smear pada warga, serta peningkatan kemampuan dalam melakukan pap smear oleh tenaga kesehatan di Kecamatan Pilangkenceng Kabupaten Madiun. Penelitian observasional deskriptif dilakukan dengan metode pendekatan cross sectional yang dilakukan pada 100 wanita, dari wilayah Puskesmas Pilangkenceng Kabupaten Madiun, dengan usia 20-70 tahun. Penilaian pretest dan post test dilakukan sebelum dan sesudah penyuluhan. Penilaian adekuasi spesimen dilakukan pada 100  sediaan  pap smear  yang diambil oleh para tenaga berdasarkan klasifikasi Papaniculaou dan sistem Bethesda. Hasil pap smear juga dibandingakan dengan hasil pemeriksaan inspeksi visual asam asetat (IVA) yang dilakukan sebelumnya. Penyuluhan terhadap masyarakat dapat meningkatkan pemahaman masyarakat tentang kanker serviks sebesar 8,05% menjadi 82,26%, sedangkan pelatihan pada tenaga kesehatan tentang tehnik pengambilan pap smear menunjukkan peningkatan pengetahuan sebesar 51,62% menjadi 100%. Adekuasi sediaan pap smear oleh tenaga kesehatan Kecamatan Pilangkenceng Kabupaten Madiun menunjukkan bahwa 99% adekuat dan memuaskan. Sepuluh persen pemeriksaan IVA menunjukkan hasil positif  dan setelah dilakukan hapusan  pap smear, kasus IVA positif tersebut menunjukkan gambaran proses keradangan dan infeksi. Kegiatan pengabdian masyarakat dapat meningkatkan pemahaman tentang deteksi dini keganasan serviks pada masyarakat dan pengetahuan para tenaga kesehatan tentang deteksi dini kanker serviks melalui metode pap smear, sehingga diharapkan bahwa tenaga kesehatan di Puskesmas Pilangkenceng siap memberikan pelayanan pap smear bagi warga. Kata kunci: adekuasi, deteksi dini, pap smear, IVA, kanker serviks.