Path Analysis on The Determinants of Cervical Cancer in Surakarta, Central Java

 Roiela Arfailasufandi1), Ambar Mudigdo2), Aris Sudiyanto2)


1)Masters Program in Public Health, Universitas Sebelas Maret

2)Faculty of Medicine, Universitas Sebelas Maret



Background: Cervical cancer is the fourth most common cancer in women world­wide. It is dis-pro­portionately affects women in low-resource countries lacking a pub­lic health infrastructure to support cancer screening. Cervical cancer prevalence in Indo­ne­sia in 2013 was 0.8%. The pur­pose of this study was to examine determinants of cer­vi­­cal cancer in Surakarta, Central Java, using path analysis model.

Subjects and Method: A case control study was conducted at Dr. Moewardi Hospital, from October to December 2018. A sample of 200 patients was selected by fixed disease sampling, con­­sisting of 100 cervical cancer patients and 100 non cervical cancer patients. The dependent va­riable was cervical cancer. The independent variables were obesity, oral contraceptive use, smo­ke exposure, parity, age at first sexual inter­course, and family history. The data were ob­tai­ned from medical record. The data were analyzed path analysis.

Results: The risk of cervical cancer was directly increased by smoke exposure (b= 2.33; 95% CI= 1.18 to 3.49; p<0.001), parity (b= 1.79; 95% CI= 0.70 to 2.89; p= 0.001), obesity (b= 1.96; 95% CI= 0.82 to 3.12; p= 0.001), and family history (b= 1.89; 95% CI= 0.66 to 3.11; p= 0.003). The risk of cervical cancer was directly decreased by delayed menarche (b= -2.01; 95% CI = -3.17 to -0.85; p= 0.001), delayed age at first intercourse (b= -1.14; 95% CI= -2.15 to -0.12; p= 0.028), oral contraceptive use (b= 0.51; 95% CI= 0.27 to 0.75; p<0.001). It was indirectly affected by edu­cation.

Conclusion: The risk of cervical cancer is directly increased by smoke exposure, parity, obe­sity, and family history. The risk of cervical cancer is directly decreased by dela­yed menarche, delayed age at first intercourse, oral contraceptive use. It is indi­rec­t­ly affected by education.

Keywords: cervical cancer, determinants, path analysis

Correspondence: Roiela Arfailasufandi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java, Indonesia. Email:


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