Comparative Study of Smart Scope® Visual Screening Test with Naked Eye Visual Screening and Pap Test

Abstract

Background: Cervical cancer is a major contributor to mortality and morbidity in women. Naked eye visual screening (NE test) and Pap test are commonly used for cervical cancer screening. Both tests have inherent limitations like low sensitivity (Pap test) and subjectivity in interpretation, lack of permanent record and overestimation (NE test). Here, Smart Scope ® visual screening test (SS test) was compared with NE and Pap tests. Smart Scope ® is a small, hand-held device that captures cervical images attached to a tablet to store data. Objective: To compare SS test with Pap and NE tests. Study Design: This prospective observational study was conducted at a tertiary care hospital in India, over 16 months. A total of 509 women in the age group of 25 to 65 years were included in the study as per the inclusion criteria. All the participants underwent Pap test, NE test and SS test. Screen positives on any one test were advised colposcopy and biopsy. Results: Out of 154 screen-positive women, 49 visited for follow-up colposcopy-guided biopsy. Nine incidental biopsies of screen-negative women were included in the data. Thus, statistical analysis was carried out based on 58 available histopathology results. Out of 58 biopsies, 8 were normal, 30 were benign lesions, 18 were precancerous and 2 were cancerous lesions. SS test was found to have a sensitivity and NPV of 100% each, PPV of 45.4% and a specificity of 36.8%. Sensitivity and specificity of NE test was 90% and 39.5% respectively, PPV was 43.9% and NPV was 88.2%. Pap smear had a sensitivity of 25% and specificity of 84.2%, PPV of 45.5% and NPV of 68.08%. Conclusion: SS test has great potential to be a primary screening test in low-resource settings due to its better sensitivity and NPV as compared to NE and Pap tests.

Accuracy of Naked Eye Visual Inspection in Early Detection of Cervical Intraepithelial Neoplasia at Zagazig University Hospitals

“…On histopathological examination we found that, 79.1% of the patients had benign in nature cervix and 20.9% had malignant in nature cervix. In agreement with our study, Rahatgaonkar et al (13) found that maximum; number of women, (300/509:58.9%), were reported to have normal cytology followed by 169 (33.2%) with inflammatory smears. They also demonstrated that on NE test, 141 were screen-positive (27.7%), and 367 were screennegative (72.1%), which is also in agreement with our results.…”

Digital cervicography for cervical cancer screening in low-resource settings: A scoping review

“…The EVA® device was another unique device which was a custom adaptation to a Samsung® Galaxy smartphone housed in a case that features additional magnification, stabilizer, optics, and attachable stand. Although this device uses a standard smartphone as an integrated component, it closely resembles a colposcope in capability and is referred to as digital colposcopy in two studies ( Goldstein et al, 2020 , Peterson et al, 2016 , Thay et al, 2019 , Gabaza et al, 2019 , Gharabaghi et al, 2019 , Oyiengo et al, 2018 , Rahatgaonkar et al, 2020 , Singhakum et al, 2018 , Srinivas et al, 2021 , Medical doctors, 2021 , Asgary et al, 2016 ).…”

“…Four other studies did not include any of the above devices: in a 2018 study by Singhakum et al, the custom device was described as “portable customized handheld digital cervicography camera,” but the article otherwise did not describe specifics ( Srinivas et al, 2021 ). In a 2019 study by Garabaghi et al, investigators described their device as a “specialized cervicography camera,” also did not include specifics ( Rahatgaonkar et al, 2020 ). Two other studies did not specify their method to obtaining cervical imaging ( Gharabaghi et al, 2019 , Rahatgaonkar et al, 2020 ).…”

“…In a 2019 study by Garabaghi et al, investigators described their device as a “specialized cervicography camera,” also did not include specifics ( Rahatgaonkar et al, 2020 ). Two other studies did not specify their method to obtaining cervical imaging ( Gharabaghi et al, 2019 , Rahatgaonkar et al, 2020 ).…”

An emerging paradigms on cervical cancer screening methods and devices for clinical trails

“…The ideology of smartscopy is that, instead of using an external flash and a device separately, the smartphones are used. This method is done after the application of a 3% solution of acetic acid to the cervix for 1 min, once the application is over a gynecologist inspects the cervix using Smartscopy with the activated flash mode pictures of the cervix ( 36 ). The recorded prominent areas revealed abnormal epithelium.…”