Determinan Kepatuhan Follow-Up Pasca Skrining DNA HPV Terhadap Keterlambatan Diagnosis Kanker Serviks Di RSU Murni Teguh Medan Tahun 2026

Jamila Rambe; Martha Sutriska Sagala

doi:10.62027/vitamedica.v4i3.807

Authors

Jamila Rambe Universitas Murni Teguh
Martha Sutriska Sagala Universitas Murni Teguh, Medan, Indonesia

DOI:

https://doi.org/10.62027/vitamedica.v4i3.807

Keywords:

cervical cancer, diagnostic delay, follow-up adherence, HPV DNA screening, social determinants

Abstract

Cervical cancer remains a leading cause of female cancer mortality despite the availability of highly sensitive HPV DNA primary screening. In line with the WHO 90-70-90 Cervical Cancer Elimination Strategy, screening coverage has increased, yet post-screening follow-up adherence has become the critical bottleneck causing diagnostic delay. This study aims to analyze determinants of follow-up adherence after HPV DNA screening and its effect on cervical cancer diagnostic delay at Murni Teguh General Hospital Medan in 2026. An analytical observational study with cross-sectional design was conducted on 208 women aged 30-65 years who underwent HPV DNA screening between January and June 2026, recruited by consecutive sampling. Data were collected using validated structured questionnaires and medical record extraction, then analyzed using Chi-square, Fisher Exact, and multiple logistic regression at 95% confidence level. Results showed that 57.2% of respondents adhered to follow-up, and among non-adherent participants 74.2% experienced diagnostic delay (>90 days). Multivariate analysis identified five dominant determinants of non-adherence: low knowledge (aOR=4.82; 95%CI 2.11-11.02), inadequate family support (aOR=3.94; 95%CI 1.78-8.72), long residential distance (aOR=3.27; 95%CI 1.55-6.89), poor health worker communication (aOR=2.98; 95%CI 1.42-6.25), and absent hospital reminder system (aOR=2.61; 95%CI 1.24-5.51). Non-adherent follow-up increased diagnostic delay risk 6.71-fold (95%CI 3.28-13.72; p<0.001). The Hosmer-Lemeshow test (p=0.612) and Nagelkerke R² (0.548) indicated a good model fit. Strengthening health literacy, family-based education, and hospital reminder systems is imperative for accelerating cervical cancer elimination.

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