Nav: Home

New tech promises easier cervical cancer screening

May 31, 2017

DURHAM, N.C. -- Duke University researchers have developed a handheld device for cervical cancer screening that promises to do away with uncomfortable speculums and high-cost colposcopes.

The "pocket colposcope" is a slender wand that can connect to many devices, including laptops or cell phones.

If widely adopted, women might even use the device to self-screen, transforming screening and cure rates in low-income countries and regions of the United States, where cervical cancer is most prevalent.

Cervical cancer is the fourth most common cancer in women, with more than 500,000 new cases occurring annually worldwide. In the United States, physicians diagnose more than 10,000 cases each year. While more than 4,000 American women die of the disease each year, the mortality rate has dropped more than 50 percent in the past four decades, largely due to the advent of well-organized screening and diagnostic programs.

While the Pap smear can be performed by a non-specialist, colposcopy requires visualization of the cervix, relying on highly trained professionals and expensive equipment that is not easily accessible to underserved populations. These factors make cervical cancer more prevalent in women living in low socioeconomic communities.

In a new paper published on May 31 in the journal PLOS One, researchers from Duke believe they have found a better way.

"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."

Current standard practices for cervical cancer screening require three things: a speculum, a colposcope and a trained professional to administer the test.

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.

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.

"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."
-end-
This work was supported by the National Institutes of Health (1R01CA195500, 1R01CA193380).

CITATION: "Design and Preliminary Analysis of a Vaginal Inserter for Speculum-Free Cervical Cancer Screening," Asiedu MN, Agudogo J, Krieger M, Miros, R, Proeschold-Bell, RJ, Schmitt JW, Ramanujam N. PLOS One, May 31, 2017. DOI: 10.1371/journal.pone.0177782

Duke University

Related Cervical Cancer Articles:

Disasters can affect cervical cancer screening for years
Screening is important for the early detection of cervical cancer, but rates were significantly affected, in some areas for years, following a devastating earthquake and tsunami in Japan.
Cervical cancer elimination possible within two decades in the US
At current levels of screening and HPV vaccination, cervical cancer incidence in the US is projected to fall below the threshold of elimination by 2038-2046.
Cervical cancer screening saves lives
Three-year interval in screening for cervical cancer is as effective as annual checkups, study finds.
Cervical cancer could be eliminated within a century
Cervical cancer could be eliminated worldwide as a public health issue within the next century.
25 years of learning to combat cervical cancer
A recent paper from the lab of Professor Sudhir Krishna at the National Centre for Biological Sciences, Bangalore, reviews the progress made in cervical cancer research over the past 25 years.
Cervical cancer screening numbers drop off in women 45-65
Virtually all cervical cancers are caused by HPV, and much of the attention in recent years has focused on preventing infections in younger women through HPV vaccination.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cost-effectiveness analysis of 12 cervical cancer screenings
This cost-effectiveness analysis incorporates women's preferences and estimates quality of life and economic outcomes for 12 cervical cancer screening strategies.
Urine test could prevent cervical cancer
Urine testing may be as effective as the smear test at preventing cervical cancer, according to new research by University of Manchester scientists.
Cervical cancer subtype rising in some sub-populations
A new study reports that a type of cervical cancer that is less amenable to Pap testing is increasing in several subpopulations of women, pointing to the growing importance of human papillomavirus (HPV) testing and vaccination
More Cervical Cancer News and Cervical Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

TED Radio Wow-er
School's out, but many kids–and their parents–are still stuck at home. Let's keep learning together. Special guest Guy Raz joins Manoush for an hour packed with TED science lessons for everyone.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.