Analisis Faktor yang Memengaruhi Keterlambatan Diagnosis dan Tatalaksana Pasien Kanker Payudara Stadium Lanjut di RSUP Prof. Dr. R. D. Kandou Manado
DOI:
https://doi.org/10.35790/msj.v8i2.67061Keywords:
kanker payudara; keterlambatan diagnosis; keterlambatan tatalaksanaAbstract
Abstract: Most breast cancer cases in Indonesia are diagnosed in advanced stages, and even metastasis, underscoring the urgency of timely intervention. This study aimed to examine the effects of knowledge, attitudes and behaviors, fear, social support, and the Covid-19 pandemic on diagnostic delay and treatment delay, as well as to evaluate the impact of diagnostic delay on subsequent treatment delay at Prof. Dr. R. D. Kandou General Hospital. This was a quantitative analyticalal study with a cross-sectional design, using purposive non-probability sampling. A total of 112 patients with advanced-stage breast cancer were recruited between October and November 2024 and assessed using a structured questionnaire. Data were analyzed using SPSS with multiple linear regression.The results showed that knowledge, attitudes and behaviors, fear, social support, and the Covid-19 pandemic significantly influenced diagnostic delay (R²=0.605), with knowledge (β=0.537) and the Covid-19 pandemic (β=0.320) being the strongest predictors. These factors also significantly contributed to treatment delay (R²=0.948), with attitudes and behaviors (β=0.935) and social support (β=0.876) demonstrating the greatest effects. Furthermore, diagnostic delay exerted a positive and significant influence on treatment delay (R²=0.304, β=0.200). In conclusion, a multidimensional approach encompassing improved public health education, psychosocial support, and streamlined healthcare pathways is essential to mitigate delays in diagnosis and treatment, ultimately enhancing clinical outcomes for breast cancer patients.
Keywords: breast cancer; diagnostic delay; treatment delay
Abstrak: Sebagian besar kasus kanker payudara di Indonesia ditemukan pada stadium lanjut, bahkan telah bermetastasis, yang menyoroti pentingnya intervensi tepat waktu. Penelitian ini bertujuan untuk menguji pengaruh pengetahuan, sikap dan perilaku, ketakutan, dukungan sosial, dan pandemi Covid-19 terhadap keterlambatan diagnosis dan keterlambatan pengobatan, serta dampak keterlambatan diagnosis terhadap keterlambatan pengobatan di RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah analitik kuantitatif dengan desain potong lintang, menggunakan non-probability sampling dengan metode purposive sampling. Penelitian dilakukan dengan menggunakan kuesioner yang diberikan kepada 112 pasien kanker payudara stadium lanjut selama bulan Oktober hingga November 2024 dan data dianalisis menggunakan SPSS. Hasil penelitian menunjukkan bahwa pengetahuan, sikap dan perilaku, ketakutan, dukungan sosial, dan pandemi Covid-19 secara bermakna mempengaruhi keterlambatan diagnosis (R²=0,605). Pengetahuan (β=0,537) dan pandemi Covid 19 (β=0,320) merupakan faktor yang paling berpengaruh terhadap keterlambatan diagnosis. Faktor-faktor ini juga secara bermakna memengaruhi keterlambatan pengobatan (R²=0,948), dengan sikap dan perilaku (β=0,935) dan dukungan sosial (β=0,876) menunjukkan pengaruh terbesar. Keterlambatan diagnostik secara positif dan bermakna memengaruhi keterlambatan pengobatan (R²=0,304, β=0,200). Simpulan penelitian ini ialah pendekatan multidimensi, termasuk peningkatan edukasi publik, dukungan psikososial, dan peningkatan alur layanan, sangat penting untuk mengurangi keterlambatan ini dan pada akhirnya meningkatkan hasil pengobatan pasien.
Kata kunci: kanker payudara; keterlambatan diagnosis; keterlambatan tatalaksana
References
1. Kementerian Republik Indonesia. Buletin kanker. Bul Jendela Data dan Inf Kesehatan. 2015;53(9):1689. Available from: https://www.slideshare.net/slideshow/buletin-kanker/117450093
2. Globocan Observatory W. Cancer Today - World. Int Agency Res Cancer. 2019;876:2018. Available from: https://publications.iarc.who.int/Databases/Iarc-Cancerbases/Cancer-Today-Powered-By-GLOBO CAN-2018--2018?utm_source=chatgpt.com
3. World Health Organization. Indonesia Source GLOBOCAN 2018. Int Agency Res Cancer. 2019;256:1–2. Available from: https://gco.iarc.who.int/media/globocan/factsheets/populations/360-indonesia-fact-sheet. pdf?utm
4. Kemenkes RI. Kasus Kanker Payudara Paling Banyak Terjadi di Indonesia. Databoks. 2019. Available from: https://databoks.katadata.co.id/layanan-konsumen-kesehatan/statistik/e3d9f1347f5e160/kasus-kanker-payudara-paling-banyak-terjadi-di-indonesia?utm
5. Kemenkes R. Panduan Penatalaksanaan Kanker Payudara. Kementeri Kesehatan Republik Indones. 2015;5–9. Available from: https://www.poijaya.org/wp-content/uploads/2021/03/PPKPayudara.pdf?utm
6. Kementerian Kesehatan Republik Indonesia. Penanggulangan kanker payudara dan kanker leher rahim. Eksp. 2015;13(p3):1576-80. Available from: https://peraturan.bpk.go.id/Details/116060/permenkes-no-34-tahun-2015?utm
7. Farida BS, Adang B, Sonar SP, Dumilah A, Hardya G, Patria WY, et al. Factors affecting delayed presentation and diagnosis of breast cancer in Asian developing countries women: a systematic review. Asian Pacific Journal of Cancer Prevention. 2021;22(10):3081–92. Doi: https://doi.org/10.31557/APJCP.2021.22.10.3081
8. Klimberg VZ, Kelly KH. Chapter 35: Diseases of the Breast. Sabiston Textbook of Surgery (21st ed). Elsevier;2022. p. 809-55.
9. Komen SG. Axillary lymph nodes [Internet]. 2020 [cited 2022 Oct 5]. Available from: https://www.komen.org/wpcontent/uploads/AxillaryLymphNodes-1.pdf
10. Pedoman Pelayanan Medik Dokter Spesialis Bedah Umum Indonesia (2nd ed). 2006. Persatuan Dokter Spesialis Bedah Umum Indonesia (PABI). Available from: https://catalog.uinsa.ac.id/index.php?id= 105446&p=show_detail&utm_source=chatgpt.com
11. Maly RC, Leake B, Mojica CM, Liu Y, Diamant AL, Thind A. What influences diagnostic delay in low-income women with breast cancer? Journal of Women’s Health (Larchmt). 2011;20(7):1017–23. Doi: https://doi.org/10.1089/jwh.2010.2105
12. Odongo J, Makumbi T, Kalungi S, Galukande M. Patient delay factors in women presenting with breast cancer in a low-income country. BMC Res Notes. 2015;8:467. Doi: https://doi.org/10.1186/s13104-015-1438-8
13. Kathrikolly TR, Shetty RS, Nair S. Opportunities and barriers to breast cancer screening in a rural community in coastal Karnataka, India: a qualitative analysis. Asian Pac J Cancer Prev. 2020;21(4):2569-75. Doi: https://doi.org/10.31557/APJCP.2020.21.9.2569
14. Anderson BO, Yip CH, Smith RA, Shyyan R, Sener SF, Eniu A, et al. Guideline implementation for breast healthcare in low-income and middle-income countries. Cancer. 2008;113(p8):2221-2243. Doi: https://doi.org/10.1002/cncr.23844
15. Moodley J, Cairncross L, Naiker T, Constant D. From symptom discovery to treatment – women's pathways to breast cancer care: a cross-sectional study. BMC Cancer. 2018;18(1):312. Doi: https://doi.org/10.1186/s12885-018-4219-7
16. Rosenstock IM. The health belief model and preventive health behavior. Health Education Monographs. 1974;2(4):354-86. Doi: https://doi.org/10.1177/109019817400200405
17. Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice (4th ed.). San Francisco, CA: Jossey-Bass; 2008.
18. Champion VL, Skinner CS. The health belief model. In: Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and Health Education: Theory, Research, and Practice (p.45-65). San Francisco, CA: Jossey-Bass; 2008.
19. Barber RM, Fullman N, Sorensen RJ, Bollyky T, McKee M, Nolte E, et al. Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. Lancet. 2017;390(23):231–66. Doi: https://doi.org/10.1016/S0140-6736(17)30818-8
20. Unger-Saldaña K. Challenges to the early diagnosis and treatment of breast cancer in developing countries. World J Clin Oncol. 2014;5(3):465-77. Doi: https://doi.org/10.5306/wjco.v5.i3.465
21. Hanna TP, King WD, Thibodeau S, Jalink M, Paulin GA, Harvey-Jones E, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020;371:m4087. Doi: https://doi.org/10.1136/bmj.m4087
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Marselus A. Merung, Denny Saleh, Ridel Torar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
