The Relationship Between Marriage Age, Parity, and Hormonal Contraceptive Use With Cervical Cancer Incidence at NTB Provincial Hospital
DOI:
https://doi.org/10.51601/ijhp.v6i1.532Abstract
Background: Cervical cancer is the most common health problem affecting the female reproductive system. It is caused by infection with the Human Papillomavirus (HPV). The most common risk factors for cervical cancer are age at marriage, parity, and use of hormonal contraceptives. Objective: To analyze the relationship between age at marriage, parity, and hormonal contraceptive use with cervical cancer incidence at the NTB Provincial General Hospital. Methods: This quantitative study used a case-control design. The sampling technique used purposive sampling with a sample size of 110 samples. Data were taken from medical records at the NTB Provincial Hospital. Data were analyzed using the Chi-square test with a significance limit of p-value <0.05.Results: It was found that most of the respondents married at the age of ≥20 years, as many as 69 (62.7%), had parity ≤3 times as many as 80 (72.7%), and used hormonal contraception as many as 58 (52.7%). The Chi-square test showed a significant relationship between age at marriage (p-value = 0.002; OR = 3,997; 95% CI = 1.742-9.170), parity (p-value = 0.005; OR = 3,917; 95% CI = 1.555-9.863), and use of hormonal contraception (p-value <0.001; OR = 4.618; 95% CI = 2.066-10.327) with the incidence of cervical cancer. Conclusion: Age at marriage, parity, and use of hormonal contraception were significantly associated with the incidence of cervical cancer at the NTB Provincial Hospital.
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References
[1] Adam, A. (2020). Early Marriage Dynamics. Al-Wardah, 13(1), 14. https://doi.org/10.46339/al-wardah.v13i1.155
[2] Adelia, C. G. (2023). Knowledge of Reproductive Health and Early Marriage in Teenage Girls. Scientific Journal of Midwifery, 10(1), 42–53.
[3] Adiesti, F., & Wari, F. E. (2020). The relationship between hormonal contraceptives and the menstrual cycle. 4(1), 6–12.
[4] Adiputra, I. M. S., Trisnadewi, N. W., Oktaviani, N. P. W., & Munthe, S. A. (2021). Health Research Methodology (R. W. & J. Simarmata (ed.)). Our Writing Foundation.
[5] Adnyana, I. G. A. (2019). Interleukin-6 (IL-6), Interleukin-8 (IL-8), and Tumor Necrosis FactorAlpha (TNF-a): Their Role in the Development and Metastasis of Tumor Cells. Medical Science: Journal of Medicine and Health, 10(2), 78. https://doi.org/10.30659/sainsmed.v10i2.4184
[6] Aini, Z., Suseno, M. R., & Anggraeni, N. P. D. A. (2024). Determinants of risk factors for cervical cancer. Indonesian Health Issue, 4(1), 19–25.
[7] Aisyah, B., & Mansur, N. W. (2021). The Impact of Child Marriage on Household Harmony in Kanrepia Village, Tombolo Pao District, Gowa Regency. Sikakilebbi Journal, 5(2), 124–140. https://doi.org/10.24252/sipakallebbi.v5i2.25593
[8] Aliya, N. A., Pasira, I., Magfira, N., Salsadila, A. P., Fadillah, N., & Undaryati, Y. M. (2025). The Latest Update on Sevics Cancer in Indonesia.
[9] Della Fera, A. N., Warburton, A., Coursey, T. L., Khurana, S., & McBride, A. A. (2021). Persistent human papillomavirus infection. Viruses, 13(2). https://doi.org/10.3390/v13020321
[10] Dewi, P. I. S., Pratama, A. A., & Astriani, N. M. D. Y. (2023). Risk Factors for Cervical Cancer Incidence at Kertha Usada Buleleng Hospital. ARTERIES: Journal of Health Sciences, 4(3), 194–199. https://doi.org/10.37148/arteri.v4i3.285
[11] Digambiro, R. A. (2024). Introduction to IVA Cervical Cancer & Pap Smear (A. Masruroh (ed.); First). The Mainstream Media.
[12] Duarsa, A. B. S., Arjita, I. P. D., Ma'ruf, F., & Aena Mardiah, Fachrudi Hanafi, Jian Budiarto, S. U. (2021). Health Research Textbook (M. Bhisma Murti (ed.); first). Faculty of Medicine, Al-Azhar Islamic University.
[13] Fahriani, E., Begum Suroyo, R., & Maryanti, E. (2023). Factors that affect cervical cancer in patients at Purni Teguh Medan Hospital. Journal of Healthy Purpose, 2(1), 80–87. https://doi.org/10.56854/jhp.v2i1.185
[14] Ferlay, J., Colombet, M., Soerjomataram, I., Parkin, D. M., Piñeros, M., Znaor, A., & Bray, F. (2021). Cancer statistics for the year 2020: An overview. International Journal of Cancer, 149(4), 778–789. https://doi.org/10.1002/ijc.33588
[15] Firdayanti, Luthfa, A., & Jingsung, J. (2023). The Relationship between Marriage Age and the Incidence of Cervical Cancer at Bahtermas General Hospital, Southeast Sulawesi Province. Journal of Health Sciences Pelita, 3(5), 38–44. https://ojs.pelitaibu.ac.id/index.php/jpasaik
[16] Fithri, N., & Agista, N. T. (2025). Risk factors for the incidence of cervical cancer at the Sipintuanginn Health Center, Dolok Pardamean District, Simalungun Regency in 2025. 361–368.
[17] Fitriyadi, K. (2025). Cervical cancer develops slowly but can be conquered. August 2024, 3–7.
[18] GLOBOCAN. (2021). Cancer Incidence in Indonesia. International Agency for Research on Cancer, 149(4), 778–789. https://doi.org/10.1002/ijc.33588
[19] Hidayah, S. N., Kusumasari, V., & Suryati. (2020). The Relationship between Marriage Age and the Incidence of Cervical Cancer in Bantul Regency, Yogyakarta. Health Sciences Media, 9(3), 200–209. https://doi.org/10.30989/mik.v9i3.603
[20] FIG. (2018). National Guidelines for Gynecological Cancer Medicine Services.
[21] Imelda, F., & Santosa, H. (2020). Early detection of cervical cancer in women. In Journal Endurance (First). Copyright © 2019 Anugrah Pangeran Jaya Press. https://repository.usu.ac.id/bitstream/handle/123456789/2300/Fulltext.pdf?sequence=1&isAllowed=y
[22] Istiqomah, N. et al. (2018). The Relationship between the Use of Hormonal Contraceptives and the Incidence of Cervical Cancer at A.W. Sjahranie Hospital in 2018. In the Journal of Poltekkes of the Ministry of Health of East Kalimantan. http://repository.poltekkes-kaltim.ac.id/id/eprint/821
[23] Ministry of Health of the Republic of Indonesia, R. (2022). Indonesian Health Profile 2022 Indonesia., K. K. R. (2020). Health Profile of Indonesia 2022.. Consider using the three paragraphs beginning with, "Consider using the three paragraphs beginning with, 'Consider using the three paragraphs beginning with,
[24] Ministry of Health of the Republic of Indonesia. (2023). Guidelines for Cervical Cancer Management. National Committee on Cancer Control.
[25] Ministry of Health of the Republic of Indonesia. (2023). KMK RI No. HK.01.7/Menkes/2015/2023/ concerning Technical Guidelines for the Integration of Primary Health Services. Ministry of Health of the Republic of Indonesia.
[26] Ministry of Health of the Republic of Indonesia. (2023). Health Profile (F. Sibuea & B. Hardhana (eds.)). Ministry of Health of the Republic of Indonesia.
[27] Khairi, S., Tawajjuh, N., Winarti, S., & Mulyani, N. M. (2020). Epidemiological Overview of the Incidence of Cervical Cancer at the Regional General Hospital of West Nusa Tenggara Province. Journal Center of Research Publication in Midwifery and Nursing, 4(1), 7–12. https://doi.org/10.36474/caring.v4i1.159
[28] Kusmiyati, Y., Prasistyami, A., Wahyuningsih, H. P., Widyasih, H., & Adnani, Q. E. S. (2019). Duration of hormonal contraception and risk of cervical cancer. Kesmas, 14(1), 9–13. https://doi.org/10.21109/kesmas.v14i1.2713
[29] Maria, N., & Izah, N. (2023). First Age of Marriage to the Incidence of Cervical Cancer at Hospital X. Journal of Health Info, 13(1), 577–583.
[30] Monayo, E. R., Basir, I. S., & Yusuf, R. M. (2020). Side Effects of the Use of Hormonal Contraceptives in the Working Area of the Buhu Health Center, Gorontalo Regency. Jambura Nursing Journal, 2(1), 131–145. https://doi.org/10.37311/jnj.v2i1.6860
[31] Museba, T. T., Howett, R. J., & Campbell, C. (2021). Are intravaginal practices associated with human papillomavirus and the development of cervical cancer? A systematic literature review. Journal of Global Health Reports, 5, 1–21. https://doi.org/10.29392/001c.21349
[32] Naghizadeh, S., Mirghafourvand, M., Mohammadi, A., Azizi, M., Taghizadeh-Milani, S., & Ganbari, H. (2021). Knowledge and viewpoint of adolescent girls regarding child marriage, its causes and consequences. BMC Women's Health, 21(1), 1–10. https://doi.org/10.1186/s12905-021-01497-w
[33] Narulita, E., & Prihatin, J. (2017). Hormonal Contraception, Types, Physiology and Its Effect on the Uterus (J. Waluyo (ed.)). UPT Publishing University of Jember. https://repository.unej.ac.id/bitstream/handle/123456789/82580/F. KIP_Buku_Erlia N_Kontrasepsi Hormonal.pdf?sequence=3&isAllowed=y
[34] Nur, S., Dwi, S. H., & Diah, N. A. (2023). The Relationship Between Young Marriage and Cervical Cancer Incidence Literature Review. https://digilib.unisayogya.ac.id
[35] Özozan, Ö. V., Pehlevan-özel, H., & Vural, V. (2025). The Relationship Between Human Papilloma Virus and Upper Gastrointestinal Cancer. 1–14.
[36] Paramitha, P. I., Jumsa, M. R., & Hapsari, Y. (2022). The Relationship between the Number of Parity and the Incidence of Cervical Cancer at the NTB Provincial Hospital in 2017-2019. Lombok Medical Journal, 1(1), 30–34. https://doi.org/10.29303/lmj.v1i1.535
[37] Pradono, J., Hapsari, D., Supardi, S., & Budiarto, W. (2018). Quantitative Research Management Handbook. In Trihono (Ed.), Publishing Institution of the Health Research and Development Agency (Vol. 53, Issue 9). Publishing Institution of the Health Research and Development Agency (LPB). www.journal.uta45jakarta.ac.id
[38] Prasasty, G. D., & Legiran. (2023). Control Case Study. Kuala Journal of Shia Medicine, 23(1), 232–236. https://doi.org/10.24815/jks.v23i1.25496
[39] Purwanti, R., Tantri, I. F., Widyastuti, N., & Probosari, E. (2025). Parity Relates to Exclusive Breastfeeding History in Stunted Toddlers. Pontianak Nutrition Journal (PNJ), 8(1), 620–628. https://doi.org/10.30602/pnj.v8i1.1799
[40] Puspitaningrum, E. (2020). Parity Prevalence Ratio to Cervical Cancer Incidence in Yogyakarta City. Health Polytechnic of the Ministry of Health of Yogyakarta. 219, 2020–2021.
[41] Putri, N. A., & Ronoatmodjo, S. (2023). Factors related to the use of long-term contraceptive methods (MKJP) in women aged 15-49 years in rural areas in Indonesia (SDKI Data Analysis 2017). Journal of Public Health, 11(5). https://doi.org/10.14710/jkm.v11i5.38572
[42] Riyanti, N., & Marpal, F. A. (2025). Barriers of Women of Childbearing Age (Wus) in Conducting Early Detection of Cervical Cancer. Journal of 'Aisyiyah Medika, 10(1). https://doi.org/10.36729/jam.v10i1.1317
[43] Rohayati, A., Ibrahim, R., & Zakiah, V. (2023). The Relationship Between The Use of Hormonal Contraceptives and The Incidence of Ca Ceviks in The Bahteramas Regional General Hospital of Southeast Sulawesi Province. Journal of Health Sciences, 3(5), 84–91. https://ojs.pelitaibu.ac.id/index.php/jpasaik
[44] Rosyada, S., Farida, & Puspitasari, N. (2022). The Relationship between Education Level and Economic Status on the Incidence of Child Marriage in Bangkalan Regency. Permas Scientific Journal: STIKES Kendal Scientific Journal, 12(4), 75–82. https://journal2.stikeskendal.ac.id/index.php/PSKM/article/view/1979/1260
[45] Salsabila, F., Ningsih, W., Nugraheni, W., & Yunariyah, B. (2024). Factors that affect early marriage in adolescents in bojonegoro. Journal of Science, 3(9), 1–7.
[46] Santoso, E. B. (2021a). Parity Relationship with Cervical Cancer Incidence at the Gynecology Polyclinic of Dr. M. Soewandhie Hospital. Echo Wiralodra, 12(2), 260–268.
[47] Santoso, E. B. (2021b). The Relationship between the First Age of Marriage and the Incidence of Cervical Cancer at the Obstetric Polygyny of RSUD X. Health Info, 11(2), 394–398.
[48] Saputro, R. A. (2019). The Relationship Between Contraceptive Use and Marital Age on the Incidence of Cervical Cancer at dr. Moewardi Hospital Surakarta. Ra'ah Journal of Pastoral Counseling Available Online At, 1(1), 29–34. http://eprints.ums.ac.id/id/eprint/69948
[49] Sari, D. P., & Nurbaya, F. (2023). Factors that cause early marriage in adolescent girls and efforts to prevent them. In F. Saefullah (ed.), E-book (First). PT Arr rad Pratama.
[50] Setiawati, S., & Hapsari, Y. (2023). Clinical Manifestations, Diagnosis, Management and Prevention of Cervical Cancer. Journal of Tropical Biology, 23(4), 382–390. https://doi.org/10.29303/jbt.v23i4.5594
[51] Shintya, L. A. (2023). The use of hormonal contraceptives with the incidence of cervical cancer. Klabat Journal of Nursing, 5(2), 90. https://doi.org/10.37771/kjn.v5i2.1018
[52] Sisca Nida Mayrita, N. H. (2019). The Relationship Between Parity and Cervical Cancer Incidence at the Wishuwardhana Cancer Foundation Surabaya. Health Scientific Journal, 7(1), 1–7.
[53] Sitompul, A. D. (2022). Overview of Adolescent Women's Knowledge of the Impact of Early Marriage at the Pangirkiran Health Center, North Padang Lawas Regency in 2021. Midwifery Study Program, Faculty of Health, Aufa Royhan University.
[54] Sjahrul Sjamsuddin. (2019). Prevention and Early Detection of Cervical Cancer. Obstetrics and Gynecology, 133, 8–13. http.www.kalbe.co.id/cdk%5Cnhttp.
[55] Scott, S., Jemal, A., & Cancer, A. (2024). Cancer Scope. 2568–2569. https://doi.org/10.1002/cncr.35444
[56] Sukwika, T. (2023). Population Determination and Sampling. In E. Novitasari (Ed.), Research Method "Basics of ICT-Based Practice and Application" (Issue August, pp. 159–173). PT. Independent Digital. https://www.researchgate.net/publication/373137498
[57] Suryana, N., & Nurwati, N. (2020). The Effect of Early Marriage on Reproductive Health and Fertility Rates.
[58] Susilowati, Y. A., Nova, F., Saptiningsih, M., & Bromm, C. C. (2023). Determinants of Parity Factor in Batu City Village, Ciomas District, Bogor City. Edu Dharma Journal: Journal of Research and Community Service, 7(1), 75. https://doi.org/10.52031/edj.v7i1.517
[59] Vanajothi, R., Srikanth, N., Vijayakumar, R., Palanisamy, M., Bhavaniramya, S., & Premkumar, K. (2022). HPV-mediated Cervical Cancer: A Systematic Review on Immunological Basis, Molecular Biology, and Immune Evasion Mechanisms. Current Drug Targets, 23(8), 782–801. https://doi.org/10.2174/1389450123666211221160632
[60] Vera Novalia. (2023). Cervical Cancer. Galenical: Journal of Medicine and Student Health, 2(1), 45–56.
[61] Wasiah, A. (2019). Parity Relationship with the Incidence of Cervical Cancer at Dr. Soegiri Hospital, Lamongan Regency. Midpro Journal, 11(2), 128. https://doi.org/10.30736/md.v11i2.121
[62] Wasila Khairun, N., Latief, S., Amalia, R., & Ikram, D. (2023). Risk Factors for the Incidence of Cervical Cancer at Ibnu Sina Hospital Makassar. Fakumi Medical Journal, 3(7), 517–525.
[63] Wierzbicka, M., San Giorgi, M. R. M., & Dikkers, F. G. (2023). Transmission and clearance of human papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma – A review. Reviews in Medical Virology, 33(1), 1–9. https://doi.org/10.1002/rmv.2337
[64] World Health Organization. (2024). UNFPA Appreciates Indonesia's Efforts to Eliminate Cervical Cancer, Encourage Integrated Vaccine Strategies, and Strengthen Screening. 2022–2024.
[65] Zainuddin, I., & Wardhana, A. (2023). Research Methods. In P. Mahir (ed.), Quantitative Approach Research Methods (First, Vol. 14, Issue 1). CV. Eureka Media Aksara.
[66] Zakiyah, F. (2020). Overview of Side Effects of Hormonal Contraceptive Use: Literature Review. Ecuadorian Gastronomy and Local Tourism., 1(69), 5–24.
[67] Zeta, N. K., Oktarlina, R. Z., Ramdini, D. A., & Wardhana, M. F. (2023). Parity relationship with cervical cancer incidence: a literature review. Medical Profession Journal of Lampung, 13(4), 490–494. http://journalofmedula.com/index.php/medula/article/view/739
[68] Zuwariyah, N., Amalia, R., & Ainiyah, S. (2021). Cervical Cancer Incidence Correlation With Hormonal Contraceptive Use. Journal of Health Sciences, 14(1), 63–67. https://doi.org/10.33086/jhs.v14i1.1210.
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