Researchers at Duke University have developed a handheld device for screening cervical cancer, it promises to do away with uncomfortable speculums and high-cost colposcopes.If widely adopted, women might be able to do self-screening, transforming screening and cure rates in low-income regions where cervical cancer is very high.Their “pocket colposcope” can connect to many devices, including laptops or cell phones.
On May 31 in the journal PLOS One, researchers from Duke believe they have found a better way of screeing cevical cancer.Quoting from the jounal;
“The mortality rate of cervical cancer should absolutely be zero percent because we have all the tools to see and treat it,” said Nimmi Ramanujam, the Robert W. Carr, Jr., Professor of Biomedical Engineering at Duke. “But it isn’t. That is in part because women do not receive screening or do not follow up on a positive screening to have colposcopy performed at a referral clinic. We need to bring colposcopy to women so that we can reduce this complicated string of actions into a single touch point.”
The speculum is a metal device designed to spread the vaginal walls apart. The colposcope is a magnified telescopic device and camera designed to allow medical professionals to look through the speculum to see the cervix, which is located three to six inches inside the vagina. Colposcopes and people who know how to use them are difficult to find in many low-income regions, both domestically and internationally.
According News Medical, Ramanujam believes she can replace at least two of these requirements. Her laboratory has developed an all-in-one device that resembles a pocket-sized tampon with lights and a camera at one end. Health providers — or even women themselves — are able to capture images of the cervix using the rounded tip of the device to manipulate its position if necessary. The device also includes a channel through which contrast agents used for the cervical cancer screening procedure can be applied.
Cervical cancer affects 500,000 women worldwide each year, resulting in more than 270,000 deaths annually. The majority of cases occur in low-income countries that cannot afford the tools commonly used in the United States. To address this challenge, researchers at Duke’s Global Women’s Health Technologies Center have developed the Pocket (Point of Care Tampon) Colposcope to screen for cervical cancer.
It has similar clinical performance to the existing standard of care Colposcope, but has lower capital and maintenance costs ($250 compared to $20,000) and increased portability. They are seeking approvals to introduce the Pocket Colposcope into Peru and East Africa where they currently have regulatory approval but require market approval.
“We recruited 15 volunteers on Duke’s campus to try out the new integrated speculum-colposcope design,” said Mercy Asiedu, a graduate student working on the project in Ramanujam’s lab. “Nearly everyone said they preferred it to a traditional speculum and more than 80 percent of the women who tried the device were able to get a good image. Those that couldn’t felt that they just needed some practice.”
Ramanujam and Asiedu are now working on clinical trials to see how their design stacks up against the traditional colposcopy used with a speculum. By using both methods to visualize the cervix, the researchers will be able to make a direct comparison.
Asiedu is also working to automate the screening process. By using image processing and machine learning to teach computers how to spot signs of precancerous and cancerous cells, Asiedu hopes to remove the need for a trained physician at any point in the screening process and shift the task to midwives, community health workers and even the women themselves.
“There have been a few other attempts to come up with a better solution, but none of them have succeeded,” said Asiedu. “One design using an inflatable cylinder proved just as uncomfortable as a traditional speculum. Another using directed airflow is just as bulky and expensive as a modern colposcope. With our handheld, low-cost design, we’re hoping to redefine the entire procedure.”
The team expects to identify actions that will maximize adoption of the Pocket Colposcope in Peru. This will be accomplished through stakeholder analysis and examination of the policy environment in Peru, as well as through comparative case studies of other technology introductions there. Although this work will yield information specific to Peru, cervical cancer is a social issue relevant across the globe.
Therefore, the team anticipates that several lessons will generalize to help guide future launches in other countries, particularly those in East Africa.Team members will submit midyear written report of the progress to date and a research plan. They will write a formal report, share it with implementing partners, lead a discussion on the report with partners, refine their recommendations and produce a final report.