Toward a Viable Solution for a See-and-Treat Paradigm for Cervical Pre-cancer in East Africa Using an Automated Colposcpectroscope

Sponsors:

  • Duke Global Health Institute

Start Date:

End Date:

  • Completed

Toward a Viable Solution for a See-and-Treat Paradigm for Cervical Pre-cancer in East Africa Using an Automated Colposcpectroscope

Cervical cancer affects the lives of 530,000 women worldwide each year and results in more than 270,000 deaths, with approximately 85% of these deaths occurring in developing countries. The decrease in the incidence of cervical cancer in developed countries has been attributed to regular screening that relies on a multi-visit, cytology-based approach Pap Smear, followed at a later time by colposcopically directed biopsy when indicated, and treatment if necessary. Employing these methods requires dedicated clinic visits for specimen collection, follow up and treatment, as well as a pathology laboratory and skilled staff. Guidelines established by the Alliance for Cervical Cancer Protection (ACCP) on strategies for screening cervical cancer in resource-limited settings, have suggested visual inspection with acetic acid with low power magnification (VIAM) followed by identified cervical lesion treated with Loop Electrosurgical Procedure (LEEP) or cryo-therapy, as the most viable strategies for reducing the mortality associated with cervical cancer in the limited resource settings. In low and middle income countries, this three-tiered approach is not always practical due to the lack of infrastructure and resources and also due to patient attrition at each level of care. Therefore, there is a critical global need for an effective see and treat paradigm in a single visit in low-resource communities. Our solution is to integrate the imaging capabilities of colposcopy with a technique known as optical spectroscopy, which can rapidly measure oxygen saturation, neovascularization and the morphological composition of local tissue sites with a pen like probe. The colpospectroscope will enable surveillance with VIAM followed by spectroscopy (in lieu of biopsy and histology) such that cervical dysplasia can be diagnosed on the spot thereby enabling a see and treat paradigm for women with cervical pre-cancer with cryotherapy and/or LEEP in a single visit.

Last updated on January 10, 2018