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All Journal Malahayati International Journal of Nursing and Health Science Holistik Jurnal Kesehatan
Siwi Pramatama Mars Wijayanti
Program Studi Kesehatan Masyarakat, Fakultas Ilmu-Ilmu Kesehatan, Universitas Jenderal Soedirman
Health Professions Nursing Public Health

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Determinan perilaku deteksi dini kanker serviks terhadap implementasi co-testing HPV DNA dan IVA di negara berkembang: Sebuah tinjauan sistematis Fitri Nuraeny; Dwi Sarwani Sri Rejeki; Siwi Pramatama Mars Wijayanti
Hik Vol. 20 No. 5 (2026): Volume 20 Nomor 5
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v20i5.3158

Abstract

Background: Cervical cancer remains a major public health concern in developing countries, where screening coverage is still low. Co-testing HPV DNA and IVA/VIA has the potential to improve early detection; however, its success is influenced by women's behavior in accessing and completing the screening pathway. Purpose: To identify the determinants of early cervical cancer detection behavior among women in developing countries in the context of co-testing HPV DNA and IVA implementation. Method: A systematic literature review based on the PICCO framework was conducted. ework. Articles reviewed included studies on HPV DNA testing and IVA/VIA/visual inspection within a single screening algorithm, either as co-testing, concurrent testing, HPV primary screening followed by VIA triage, or screen–triage–treat. Study quality was assessed using JBI Critical Appraisal Tools, and data were synthesized narratively based on individual, social, healthcare service, economic, and cultural factors. Results: Ten primary studies were analyzed. Dominant determinants included knowledge, risk perception, acceptance of screening methods, stigma, partner/family support, transportation costs, service distance, informal employment, geographic access, follow-up systems, number of visits, HPV DNA result turnaround time, and availability of IVA/VIA triage on the same day. HPV self-sampling, single-visit services, community-based approaches, and active recall systems have the potential to increase uptake and reduce loss to follow-up. Conclusion: Behavioral determinants of early cervical cancer detection in the context of co-testing HPV DNA and IVA are multidimensional. Screening programs in developing countries need to integrate education, community-based approaches, easy service access, rapid triage, and active follow-up to increase participation and screening compliance.   Keywords: Cervical Cancer Screening Behavior; Co-Testing Developing Countries; Early Detection Behavioral Determinants; HPV DNA Testing Uptake; Visual Inspection Acetic Acid.
Diagnostic accuracy of urine-based HPV DNA testing for cervical cancer screening: A systematic literature review Firdaus Cahya Saputra; Dwi Sarwani Sri Rejeki; Siwi Pramatama Mars Wijayanti
MIN Vol. 9 No. 7 (2026): Volume 9 Number 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/min.v9i7.4261

Abstract

Background: Cervical cancer remains a major global health challenge, particularly in low- and middle-income countries where screening uptake is limited. Clinician-collected cervical HPV testing is the current reference standard, yet conventional sampling procedures are often invasive, uncomfortable, and stigmatized, reducing acceptability among under-screened women. Urine-based HPV DNA testing has therefore emerged as a promising non-invasive alternative. Purpose: To critically synthesize and appraise existing evidence on the diagnostic accuracy of urine-based HPV DNA testing—specifically its sensitivity, specificity, and concordance—as well as the methodological factors influencing these metrics, in comparison with clinician-collected cervical HPV DNA samples for cervical cancer screening. Method: This systematic review, conducted in accordance with PRISMA 2020 guidelines, synthesized evidence from PubMed, Scopus, and ScienceDirect published between 2016 and 2026. Thirty eligible studies were included from 455 identified records, all evaluating the diagnostic accuracy of urine-based HPV DNA testing compared with clinician-collected cervical samples. Results: Findings revealed moderate-to-high concordance, with sensitivity ranging from 44% to over 95% and consistently high specificity. Superior diagnostic performance was observed in studies employing first-void urine collection and validated PCR-based assays, while methodological heterogeneity in collection procedures, preservation methods, and assay platforms remained evident. Conclusion: Urine-based HPV DNA testing offers a feasible, non-invasive approach to expand cervical cancer screening, particularly for under-screened populations. However, methodological standardization and large-scale validation are essential before adoption as a primary screening strategy.
Co-Authors Dwi Sarwani Sri Rejeki Firdaus Cahya Saputra Fitri Nuraeny