Universitas Indonesia (UI), through an open session led by UI Rector, Prof. Ari Kuncoro, S. E., M. A., inaugurated Prof. dr. Yusra, Sp.PK., SubSp.GEH(K)., Ph.D., as a permanent professor in the field of Hepatogastroenterology Clinical Pathology, Faculty of Medicine (FK) at the IMERI Hall FKUI, Salemba Campus, on Saturday, November 9, 2024. On that occasion, Prof. Yusra delivered an inaugural speech titled “Peran Patologi Klinik dalam Mengembangkan Pemeriksaan Non Invasif untuk Skrining dan Deteksi Dini Kanker Kolorektal dalam Strategi Pencegahan dan Pengendalian Kanker Nasional”(The Role of Clinical Pathology in Developing Non-Invasive Examination for Screening and Early Detection of Colorectal Cancer in the National Cancer Prevention and Control Strategy).
She explained that colorectal cancer is a malignancy in the colon and rectum tissue. This cancer is one of five types of cancer that are a priority in the national strategy, with a high mortality rate. Screening and early detection are one of the six pillars set by the government to deal with cancer in Indonesia, which are included in the National Cancer Prevention and Control Strategy 2024-2034.
“I raised this title to explain to all of us, the role of Clinical Pathology in developing non-invasive examinations that are useful in screening and early detection of colorectal cancer,” said Prof. Yusra. She further said that the costs incurred by BPJS for cancer treatment in 2023 increased by almost 50% to 5.9 trillion compared to the previous year. Colorectal cancer is the second highest cost after pancreatic cancer.
Seeing the magnitude of the cancer problem in Indonesia, the Ministry of Health has created a book, Rencana Kanker Nasional 2024-2034 (National Cancer Plan 2024-2034), which presents six strategies to reduce cancer incidence and increase cancer survival rates, one of which is the screening and detection strategy. “The function of the screening test is to assess the possibility of someone who is asymptomatic having a certain disease, with the aim of preventing disease or death from the disease. Colorectal cancer screening tests are important as a government program because this disease has a fairly long asymptomatic period,” said Prof. Yusra.
It takes approximately 10-15 years for colorectal cancer to become symptomatic. If so, then the disease process is already severe and metastatic. Through this screening test, it is hoped that colorectal cancer can be diagnosed at an early stage, so that disease management can be carried out as quickly as possible, thereby reducing morbidity and mortality rates.
The recommended screening methods for colorectal cancer are digital rectal examination, performed once at the age of over 50 years and repeated if there are symptoms, fecal occult blood examination and fecal DNA examination for early-stage colorectal cancer detection, and endoscopic examination (flexible sigmoidoscopy, colonoscopy) and radiological examination (barium enema with double contrast and CT colonoscopy) for advanced cancer lesion detection which is performed every 5 years.
“Why is a non-invasive examination needed for colorectal cancer screening? From various publications it is known that there is high non-compliance in the community in conducting colorectal cancer screening with colonoscopy. Some of the reasons are discomfort, embarrassment, pain, and fear of positive results are the most common obstacles,” said Prof. Yusra.
She explained that feces can generally be excreted through the anus, and contain valuable information about the health of the digestive system and liver. The presence of bleeding, normal and pathological cells, including secreted substances, digestive waste, normal and pathological bacteria, can all be detected in feces. Therefore, feces are a good sample for detecting digestive tract diseases, which are obtained in a non-invasive way, so that it can reduce the discomfort and risks that patients often experience due to invasive procedures.
Furthermore, to analyze the sample, Prof. Yusra said, the role of Clinical Pathology is needed in developing non-invasive examinations. “Clinical Pathology is a branch of medicine that studies diseases through the analysis of body fluid samples, such as blood, urine, and other body fluids, including feces. The role of Clinical Pathology in colorectal cancer includes screening examinations and early diagnosis including examination of fecal occult blood, fecal DNA/RNA, and various tumor metabolites,” said Prof. Yusra.
Clinical Pathology also plays a role in monitoring treatment and prognosis, such as through the examination of the CEA tumor marker. And now, microbiota and metabolite examinations in the form of short chain fatty acids have begun to be developed to assess digestive tract health. In the future, fecal transplantation will begin to be used for digestive tract disease therapy, and it is a challenge for Clinical Pathology in developing laboratory examinations.
Until now, Prof. Yusra has been actively conducting various studies and has been published in various national and international journals. Some of them published this year are titled The Comparison of Laboratory Parameters of COVID-19 Patients in Universitas Indonesia Hospital Before and During Delta Variant Period; Safety and Effectiveness of Seahorse Extract (Hippocampus Comes L.) on The Hematological Profile and Body Weight of Male Rats Induced by Depo Medroxyprogesterone Acetate; and Perceptions, Practices, and Associated Factors Towards Expressed Breastfeeding Among Mothers in Jakarta, Indonesia.
She completed his medical education at FKUI in 1994, then continued to complete her education as a Clinical Pathology Specialist Doctor in 2005. In 2012 he received his Doctor of Philosophy degree in Medical Science, Kobe University, Japan. Furthermore, in 2020 he successfully obtained his Hepatogastroenterology Consultant degree from the Indonesian Clinical Pathology College.
