THE RELATIONSHIP BETWEEN KNOWLEDGE AND ATTITUDE OF WOMEN OF REPRODUCTIVE AGE ABOUT LEBER RAHUM CANCER WITH BEHAVIOR OF UTILIZING TONT INSPECTION SERVICE VISUALK ACETIC ACID (IVA) IN PANOMBEAN PUSKESMAS WORKING AREA

Knowledge about cervical cancer in Indonesia is still relatively low, only about 246 of women in Indonesia know about cervical cancer, so researchers are interested in examining the relationship between knowledge and attitudes of women of childbearing age about cervical cancer and the behavior of using Acetic Acid Visual Inspection (IVA) in Indonesia. Work Area of the Panombean Panei Health Center in 2017. This research is descriptive in nature which was carried out in the Work Area of the Panombean Panei Health Center in May-July 2017 with a population of 300 people and a sample of 75 people. The results of this study indicate that the majority of high school respondents were 40 people (53.3″o), a minority of junior high school were 16 people (21,390), the majority were farmers, namely 27 people (3,699), a minority of civil servants, namely 10 people (13,390), the majority of knowledge was lacking, namely as many as 62 people (82.7Y40), the minority of good knowledge is 13 people (17.3”6), the majority disagrees is 55 people (73.396), the minority agrees is 20 people (26.7”0), the majority have never used the Acetic Acid Visual Inspection examination ( IVA), namely 60 people (80Y6), the minority had used the Acetic Acid Visual Inspection (IVA) examination, namely 15 people (2096). From the results of the chisguare test it was concluded that knowledge has a relationship with the behavior of utilizing the Acetic Acid Visual Inspection (IVA) examination in the Work Area of the Panombean Panei Health Center in 2017, because the p value < 0.05.


INTRODUCTION
Cancer is one of the main causes of death worldwide. In 2012 cancer was the cause of death for around 8.2 million people. The incidence of cancer in the world is entering a critical period where every year the incidence of cancer is increasing. There are many types of cancer in the world, one of which is cervical cancer. Until now cervical cancer is the most common cause of cancer death in developing countries. The incidence rate of this disease is low in women under 25 years of age but the incidence increases in women aged 35 to 40 years and reaches a maximum point in their 50s (Reference Book of North Sumatra Provincial Health Office 2016).
Based on GLOBOCAN data, the International Agency for Research on Cancer (IARC) in the Indonesian Ministry of Health (2012), the incidence of cervical cancer in Indonesia is 16 per 100,000 women. WHO in a journal published in 2012 with the title: "HPV and Cervical Cancer in The World 2012 Report" said an estimated 15050 new cases of cervical cancer appear each year and as many as 7566 cases of death occur due to cervical cancer. Based on the 2013 Riskesdas interview, it was found that the prevalence of cancer patients in all ages in Indonesia was 1.4 "6, where cancer is the number 2 cause of death in Indonesia. Every year, 12 million people in the world suffer from cancer and 7.6 million of them die. It is estimated that by 2030 this event could reach up to 26 million people and 17 million of them will die from cancer, especially for poor and developing countries the incidence will be faster (Bulletin of Health Data and Information Semester I, 2015). Cervical cancer is an important health problem for women worldwide. Cervical cancer is abnormal cells in the cervix, namely the lower part of the uterus that protrudes into the female genitalia. Cervical cancer at this stage often does not show any typical signs or symptoms. even no symptoms at all (Ministry of Health RI, 2012). Cervical cancer is a malignancy that occurs in the cervix and is caused by infection with the human papilloma virus (HPV). This cancer has attacked more than 1.4 million women worldwide (Samadi, 2011).
However, in practice, this method still encounters obstacles such as the reluctance of women to be examined because they are embarrassed. Other causes such as doubts about the importance of the examination, lack of knowledge, and fear of feeling sick during the examination (Irawan, 2010). Knowledge about cervical cancer in Indonesia is still relatively low, only about 2Y6 of women in Indonesia know about cervical cancer (Retnosari, 2006). For this reason, the researcher wanted to understand more about the use of IVA method services as a cervical cancer prevention method at the Siborongborong Health Center, North Tapanuli Regency and relate it to the level of knowledge of women of reproductive age couples about cervical cancer itself.

Types of research
This type of research is descriptive with a cross-sectional design which aims to determine the relationship between the knowledge and attitudes of women of childbearing age about cervical cancer and the behavior of using the Acetic Acid Visual Inspection (IVA) Test Service in the Work Area of the Panombean Panei Health Center in 2017.

Location and Time of Research
The research location was carried out in the Panombean Panei Health Center Working Area.

Research time
This research was conducted in May-July

Data analysis
Data analysis was carried out in stages which included univariate, bivariate, 1. Univariate analysis Univariate analysis was performed to get an overview of each dependent variable and independent variable. The data will be presented in the form of a frequency distribution. Bivariate analysis is to determine whether there is a relationship between the independent variables (categorical) and the independent variables (categorical) by using the Kai Square Test or Chi Sguare. 3. To determine the significance of the results of statistical calculations, a significance limit of 0.05 was used. Thus if the p value < 0.05 then the calculation results are statistically significant and if p -0.05 then the results of the statistical calculations are not significant.

RESULTS AND DISCUSSION Based on the results of research conducted regarding the relationship between knowledge and attitudes of women of childbearing age about cervical cancer with the behavior of using acetic acid visual inspection (IVA)
In the Panombean Panei Working Area in 2017 with 75 respondents, the following can be discussed:

Cross Table of Relationship between Knowledge of Women of Reproductive Age about Cervical Cancer and the Behavior of Utilizing Acetic Acid Visual Inspection (IVA) Examination in the Working Area of Panombean Panei Health Center in 2017
From the results of the chisguare test the cross table of knowledge and behavior obtained a p value of 0.000. It can be concluded that knowledge has a relationship with the behavior of utilizing Acetic Acid Visual Inspection (IVA) examinations in the Work Area of the Panombean Panei Health Center in 2017, because the p value < 0.05.
According to Aulia (2012) the lack of public knowledge, especially mothers regarding cervical cancer and the reluctance to carry out early detection causes the majority ("70"6) of patients to go to health services to be advanced and difficult to treat. Early detection methods that can be used depend on the availability of resources. A good early detection method has several requirements, namely accurate, reproducible, cheap, easy to work on and follow up on, acceptable, and safe. Several methods recognized by WHO are as follows (Depkes RI, 2008)

Cross Table of Relationship between Attitudes of Women of Reproductive Age about Leber Womb Cancer and Behavior of Utilizing Acetic Acid Visual Inspection Examination (IVA)
In the Work Area of the Panombean Panei Health Center in 2017. From the results of the chisguare test, cross-table attitudes and behavior obtained a p value of 0.000. It can be concluded that attitude has a relationship with the behavior of utilizing Acetic Acid Visual Inspection (IVA) examinations in the Work Area of the Panombean Panei Health Center in 2017, because the p value < 0.05. Before someone takes a stand. it can be influenced by several factors including age, education and employment. With increasing age, there will be changes in the physical and psychological (mental) aspects where this psychological aspect is the level of one's thinking more mature and mature. Education means guidance given by someone to other people so they can understand. It cannot be denied that the higher a person's education, the easier it is for them to receive information and in the end the more knowledge they have. The work environment can make a person gain experience and knowledge either directly or indirectly.  (Robbins and Judge, 2008) the process of forming attitudes begins with receiving stimuli from various sources. It can also be influenced by personal factors, which determine the perception not of the type or form of stimuli, but the characteristics of the person who responds to the stimuli. In line with this, a person's perception is determined by two main factors, namely past experience and personal factors obtained through the learning process and past experience.

CLOSING Conclusion
1. The majority have the last high school education, namely 40 people (53.3%), while the minority have the last junior high school education, namely 16 people (21.3%) 2. The majority have jobs as farmers, namely 27 people (36%), while the minority have civil servant jobs, namely 10 people (13.36). 3. The majority have less knowledge, namely as many as 62 people (82.7%) while the minority have good knowledge, namely as many as 13 people (17.3%). 4. The majority had an attitude of disagreeing, namely as many as 5S people (73.36), while the minority had an attitude that agreed, namely as many as 20 people (26.7%). 5. The majority had the behavior of never utilizing the Acetic Acid Visual Inspection (IVA) examination, namely as many as 60 people (806), while the minority had the behavior of having used the Acetic Acid Visual Inspection (IVA) inspection, namely as many as 15 people (2020). 6. Knowledge has a relationship with the behavior of utilizing Acetic Acid Visual Inspection (IVA) examinations in the Working Area of the Siborongborong Health Center in 2016, because the results of the chisguare test p value < 0.05. 7. Attitude has a relationship with the behavior of utilizing the Acetic Acid Visual Inspection (IVA) examination in the Work Area of the Panombean Panei Health Center in 2017, because the results of the chisguare test p value < 0.05.