Washington: A newly-developed handheld device for cervical cancer screening is promising to do away with uncomfortable speculums and high-cost colposcopes.
Duke University researchers' "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.
While the Pap smear can be performed by a non-specialist, colposcopy requires visualisation 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.
"The mortality rate of cervical cancer should absolutely be zero percent because we have all the tools to see and treat it," said researcher Nimmi Ramanujam. "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 researcher Mercy Asiedu. "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 visualise the cervix, the researchers will be able to make a direct comparison.
The study appears in the journal PLOS One....