Relationship of Knowledge, Attitude with SADARI Behavior as an Early Detection of Breast Cancer in Students of The Faculty of Public Health

Breast cancer cases are quite high in Indonesia, namely 42 per 100.000 population and are the main cause of death for women in Indonesia. The purpose of this study was to analyze the relationship between knowledge and attitudes with awareness behavior (self-breast examination) in students of the Faculty of Public Health, Teuku Umar University, Meulaboh. The research design was cross sectional with a quantitative approach with univariate and bivariate analysis. The population of this study were female students at the Faculty of Public Health, Teuku Umar University Meulaboh, West Aceh Regency with a sample of 143 female students. The results of the study concluded that most of the respondents had never realized it as many as 84 people (58.7%). The factors of knowledge and attitudes about awareness are related to the behavior of being aware


Introduction
Data from the World Health Organization (WHO) in the Indonesian Ministry of Health (2015) that cancer is the second leading cause of death in the world at 13% after cardiovascular disease. Breast cancer cases occurred in women aged 50 years and over (78%), while in women aged 40 years (6%). However, many women who are 30 years old suffer from this deadly disease. This disease generally occurs in women, but can also occur in men.
According to GLOBOCAN (IARC) in 2012, it was found that 43.3% of cancer cases were breast cancer cases and 12.9% of deaths were due to breast cancer. GLOBOCAN data show that breast cancer has a lower mortality rate than the percentage of new cases, so that if breast cancer can be detected and treated early, the chances of cure will be higher. The problem in implementing BSE as an early detection method for breast cancer is that it is rarely done correctly. Only 25% to 30% do BSE properly and regularly every month (Kemenkes RI, 2012).
Previous research studies conducted by researchers on January 14, 2019 at FKM UTU Meulaboh, with the interview method on BSE to 15 students of the UTU FKM, and only 5 (five) people who answered correctly. This study aims to analyze the relationship between knowledge and attitudes about awareness with conscious behavior in the early detection of breast cancer among Meulaboh students.

Methods
The method used quantitative analytic with crosssectional approach. The sample of this research was 143 students of FKM UTU. The data analysis of this research is univariate and bivariate analysis. The tool used for data collection in this study was a questionnaire.

Results
The results of the univariate analysis of age factors, family history of suffering from cancer, history of respondents suffering from cancer, knowledge, attitudes about awareness and conscious action can be seen in the tables below: Based on the results of the analysis in table 1, it is known that the average age of female students is 19.4 http://jurnal.utu.ac.id/jkesmas/article/view/ years, the average knowledge of female students is 7.66 and the average score of female attitudes is 33.06. Based on this research, it is known that most of the respondents never realized, namely as many as 84 people (58.7%) From table 3 it is known that a greater proportion (95.8%) of female students had no family history of suffering from breast cancer, namely 95.8% and most respondents had no history of suffering from cancer, as much as 97.8%. Meanwhile, respondents with good and less knowledge levels were relatively the same, respectively 72 (50.3%) and 71 (49.7%), and female students with good attitudes were 78 people (54.5%).

Bivariate Analysis
Bivariate analysis was conducted to determine several variables that may be related to awareness behavior in female students, between the independent variable and the dependent variable

SADARI Behavior
The appearance of a lump in the breast can actually be detected quickly by self-examination. BSE is a way to check your own breasts. Self-examination is recommended to be carried out regularly, namely once a month. The results showed that out of 143 students, West Aceh Regency, 59 people (41.3%) had ever realized it, and more than half of the students who never did Sadari were 84 people (

Relationship Between Respondents Knowledge with Behavior SADARI as early Detection of Breast Cancer
Based on the results of the study, it is known that there is a relationship between female students knowledge SADARI with SADARI behavior of students. This research is in line with research conducted by Handayani (2008) Reynaldi, F et al., (2020) in household waste in Johan Pahlawan district, Aceh Barat. The research by Poppy, C, P & Farismi, T, N (2015) at the Sibigo Public Health Center, West Simeulue District, Simeulue Regency, research by husna, A & Fahlevi, M, I (2020) in young women at High school West aceh regency.

Relationship between Respondents' Attitudes with Behavior SADARI as Early Detection of Breast Cancer.
The results of research at FKM UTU show that http://jurnal.utu.ac.id/jkesmas/article/view/ attitudes have a relationship with conscious behavior, with a p value of 0.013 and an OR value (95% CI) of 2.355, meaning that respondents who have good attitudes have a chance to implement Sadari twice compared to respondents who have less attitudes. This result is in line with the research conducted by Rianti, at UPN "Veteran" Jakarta Faculty of Medicine students, research by Susi Adelia et al., (2017) that there is a significant relationship between the level of knowledge and the conscious behavior of the student at STIKES Nani Hasanuddin Makasar, Sherin Ishaaque et al., (2019 For the FKM UTU Meulaboh, Aceh Besar District, to add KIA and Kespro subject matter to the public health curriculum on breast self-examination (realize) as early detection of breasts and increase awareness of continuous health education and also delivery of information through leaflets. Pocket books are needed by students of FKM UTU Meulaboh Aceh Besar District to increase knowledge and change attitudes so as to foster student interest and motivation for early detection of breast cancer by realizing it.