Handheld Medical Device to Improve Access to Cervical Cancer Screening

Researchers at Duke University have developed a slim, handheld medical device that could revolutionize cervical cancer screening by putting the power in the hands of the women themselves. The so-called “pocket colposcope” could be an alternative to the traditional and high-cost speculum/colposcope combo that can only be used by highly-trained professionals.

What’s more, the wand-like medical device can connect to laptops and smartphones to capture images of the cervix. While the device could easily be implemented by family doctors, the researchers say that self-screening could have the most impact in low-income areas of the US where access to trained medical professionals is not always available.

Over 500,000 new cases of cervical cancer are diagnosed around the world each year, making it the fourth most common cancer type in women. In the US alone, over 10,000 women are diagnosed with cervical cancer annually, with more than 4,000 patients dying as a result of the disease.

The introduction of screening programs for women using the Pap smear has been credited with helping to cut the mortality rate of cervical cancer in half in the last 40 years. While this improvement is promising, the Duke researchers say that women still face barriers when it comes to accessing diagnostic services for cervical cancer screening.

Patients with abnormal Pap test results may be referred to receive a colposcopy to visualize the cervix. Currently, this procedure can only be performed by specialists using expensive medical devices – services that are often less accessible to women living in low-income areas.

“The mortality rate of cervical cancer should absolutely be zero percent because we have all the tools to see and treat it,” said Dr. 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.”

Ramanujam and her team developed a slimmer colposcope device equipped with a camera and light to capture images of the cervix. The researchers published their findings in the journal, PLOS One.

Since the medical device is designed to be used by general practitioners and patients alike, the research team asked a small group of volunteers to test the colposcope. In addition to asking the women how comfortable the device was to use, they also evaluated their ability to take useable images for cervical cancer screening.

“We recruited 15 volunteers on Duke’s campus to try out the new integrated speculum-colposcope design,” said lead author 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.”

The researchers’ next steps are to test how well the pocket colposcope performs when compared to the traditional procedure using a speculum and colposcope. In addition, Ramanujam and her team are looking to use image processing software coupled with machine learning to remove the need for a physician to interpret the image results. Ideally, they say that community health workers – in partnership with women – would take up the responsibility of cervical cancer screening using the colposcope device, making the procedure more accessible to patients across the US.