Point-of-care test for cervical cancer in LMICs

Abstract

Cervical cancer screening using Papanicolaou's smear test has been highly effective in reducing death from this disease. However, this test is unaffordable in low- and middle-income countries, and its complexity has limited wide-scale uptake. Alternative tests, such as visual inspection with acetic acid or Lugol's iodine and human papillomavirus DNA, are sub-optimal in terms of specificity and sensitivity, thus sensitive and affordable tests with high specificity for on-site reporting are needed. Using proteomics and bioinformatics, we have identified valosin-containing protein (VCP) as differentially expressed between normal specimens and those with cervical intra-epithelial neoplasia grade 2/3 (CIN2/CIN3+) or worse. VCP-specific immunohistochemical staining (validated by a point-of-care technology) provided sensitive (93%) and specific (88%) identification of CIN2/CIN3+ and may serve as a critical biomarker for cervical-cancer screening. Future efforts will focus on further refinements to enhance analytic sensitivity and specificity of our proposed test, as well as on prototype development.

LXR/RXR pathway signaling associated with triple-negative breast cancer in African American women

“…Western blot analysis was performed according to Mohammed et al12 To extract protein from cell lines, lysis buffer was added to cultured cells at 75% confluence and protein was transferred to tubes and centrifuged. The protein concentration for each sample was determined using the Pierce bicinchoninic acid (BCA) Protein Assay Kit (Thermo Fisher Scientific).…”

Qualitative Evidence Synthesis on Self-Collection for Human Papillomavirus–Based Cervical Screening: Protocol for Systematic Review

“…A global review by Kouliopoulos et al [ 8 ] of studies conducted between 1992 and 2015 showed that HPV testing has higher sensitivity and specificity than those of conventional cytology methods and allows for less frequent screening. When provided at point-of-care, patients receive their results in a shorter time frame (60-90 minutes on average, compared to up to 2 weeks for Pap smears) allowing for faster turnaround, more timely treatment, and reduction in patients lost to follow-up [ 4 , 9 , 10 ]. Research from Goldie et al [ 11 ] demonstrated that HPV-based screening for women once they have reached 35 years of age potentially reduces the lifetime risk of cervical cancer by 36%.…”

Feasibility of thermocoagulation in a screen-and-treat approach for the treatment of cervical precancerous lesions in sub-Saharan Africa

“…Such disproportion is likely due to the difficulties in the implementation of a cytology-based screening program, which requires multiple-day, long-distance visits and important human and financial resources [2]. The availability of Point-of-Care technologies and visual inspection methods is progressively changing our understanding of CC screening and giving way to the possibility of offering screening and, if needed, treatment in a 1-day session [3, 4]. This same-day screen-and-treat strategy has proven to be more effective than cytology-based screening in terms of both patient compliance and costs [5].…”