Use of Smartphones as Adjuvant Tools for Cervical Cancer Screening in Low-Resource Settings

Gauthier, D.; Wisniak, Ania; Catarino, Rosa; Rossum, Annabelle Faure van; Meyer-Hamme, Ulrike; Negulescu, Raluca Anca; Scaringella, Stefano; Jinoro, Jeromine; Vassilakos, Pierre; Petignat, Patrick

doi:10.1097/lgt.0000000000000136

Cited by 45 publications

(62 citation statements)

References 12 publications

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“…An example of effective low-cost leveraging of mobile technologies comes from work in Ambanja, Madagascar, where smartphones were used to take and transmit high-definition images for the detection of cervical intraepithelial neoplasia of grade 2 or worse as an adjunct to standard on-site examination. 82 …”

Section: Using Social Media and Mhealth Apps In Low-resource Settingsmentioning

confidence: 99%

Social Media and Mobile Technology for Cancer Prevention and Treatment

Prochaska

Coughlin

Lyons

2017

American Society of Clinical Oncology Educational Book

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OVERVIEW Given the number of lives affected by cancer and the great potential for optimizing well-being via lifestyle changes, patients, providers, health care systems, advocacy groups, and entrepreneurs are looking to digital solutions to enhance patient care and broaden prevention efforts. Thousands of health-oriented mobile websites and apps have been developed, with a majority focused upon lifestyle behaviors (e.g., exercise, diet, smoking). In this review, we consider the use and potential of social media and mHealth technologies for cancer prevention, cancer treatment, and survivorship. We identify key principles in research and practice, summarize prior reviews, and highlight notable case studies and patient resources. Further, with the potential for scaled delivery and broad reach, we consider application of social media and mHealth technologies in low-resource settings. With clear advantages for reach, social media and mHealth technologies offer the ability to scale and engage entire populations at low cost, develop supportive social networks, connect patients and providers, encourage adherence with cancer care, and collect vast quantities of data for advancing cancer research. Development efforts have been rapid and numerous, yet evaluation of intervention effects on behavior change and health outcomes are sorely needed, and regulation around data security issues is notably lacking. Attention to broader audiences is also needed, with targeted development for culturally diverse groups and non-English speakers. Further investment in research to build the evidence base and identify best practices will help delineate and actualize the potential of social media and mHealth technologies for cancer prevention and treatment.

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Section: Using Social Media and Mhealth Apps In Low-resource Settingsmentioning

confidence: 99%

Social Media and Mobile Technology for Cancer Prevention and Treatment

Prochaska

Coughlin

Lyons

2017

American Society of Clinical Oncology Educational Book

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“…While not specific to cervical cancer screening, previous studies have found a positive association between telemedicine and increased access to specialized care, decreased costs to patient, reduced treatment costs at earlier stage of disease, and overall increased socioeconomic returns [ 7 ]. With increasing access to internet and mobile phone connectivity, telemedicine offers potential solutions for improving access and quality of cervical screening for women in low-resource settings as well as those who have reduced access to screening services due to geographical station [ 8 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Colposcopy telemedicine: live versus static swede score and accuracy in detecting CIN2+, a cross-sectional pilot study

et al. 2018

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BackgroundThis cross-sectional pilot study evaluates diagnostic accuracy of live colposcopy versus static image Swede-score evaluation for detecting significant precancerous cervical lesions greater than, or equal to grade 2 severity (CIN2+).MethodsVIA or HrHPV positive women were examined using a mobile colposcope, in a rural clinic in Kolkata, India. Live versus static Swede-score colposcopy assessments were made independently. All assessments were by gynecologists, junior or expert. Static image assessors were blinded to live scoring, patient information and final histopathology result. Primary outcome was the ability to detect CIN2+ lesions verified by directed biopsies. Diagnostic accuracy was calculated for live versus static Swede-score in detecting CIN2+ lesions, as well as for interclass correlation.Results495 images from 94 VIA positive women were evaluated in this study. Thirteen women (13.9%) had CIN2+ on biopsy. No significant difference was found in the detection of CIN2+ lesions between live and static assessors (area under curve = 0.69 versus 0.71, p = 0.63). A Swede-score of 4+, had a sensitivity of 76.9% (95% CI 46.2–95.0%) and 84.6% (95% CI 54.6–98.1%), for live- and static-image assessment respectively. The corresponding positive predictive values were found to be 90.9% (95% CI 75.7–98.1%) and 92.6% (95% CI 75.7–99.1%). The interclass correlation was good (kappa statistic = 0.60) for the senior static assessors.ConclusionsSwede-score evaluation of static colposcopy images was found to reliably detect CIN2+ lesions in this study. Larger studies are needed to further develop the colposcopy telemedicine concept which may offer reliable guidance in management where direct specialist input is not available.Trial registrationEthical approval of the study was obtained by the Chittaranjan National Cancer Institute (CNCI) Human Research Ethics Committee (4.311/27/2014). The trial was retrospectively registered in the Clinical Trails Registry of India CTRI/2018/03/012470.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0569-1) contains supplementary material, which is available to authorized users.

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“…A previous study conducted in Madagascar has shown that off-site detection of cervical lesions based on the evaluation of smartphone photographs was more reliable than on-site diagnosis alone [5]. The aim of this study was to assess the clinical performance of D-VIA and D-VILI examinations for diagnosing cervical lesions in LMICs.…”

Section: Introductionmentioning

confidence: 99%

A Smartphone-Based Approach for Triage of Human Papillomavirus-Positive Sub-Saharan African Women: A Prospective Study

Urner¹,

Delavy²,

Catarino³

et al. 2017

JMIR Mhealth Uhealth

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BackgroundSub-Saharan African countries are marked by a high incidence of cervical cancer. Madagascar ranks 11th among the countries with the highest cervical cancer incidence worldwide.ObjectiveThe aim of the study was to evaluate the performances of digital smartphone-based visual inspection with acetic acid (D-VIA) and Lugol’s iodine (D-VILI) for diagnosing cervical precancer and cancer.MethodsHuman papillomavirus (HPV)-positive women recruited through a cervical screening campaign had D-VIA and D-VILI examinations with endocervical curettage (ECC) and cervical biopsy. Three images were captured for each woman (native, D-VIA, D-VILI) using a smartphone camera. The images were randomly coded and distributed on 2 online databases (Google Forms). The D-VIA form included native and D-VIA images, and the D-VILI form included native and D-VILI images. Pathological cases were defined as cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Physicians rated the images as non-pathological or pathological. Using the ECC and cervical biopsy results as references, the sensitivity and specificity of D-VIA and D-VILI examinations for each and all physicians were calculated.ResultsAltogether, 15 clinicians assessed 240 images. Sensitivity was higher for the D-VIA interpretations (94.1%; 95% CI 81.6-98.3) than for the D-VILI interpretations (78.8%; 95% CI 54.1-92.1; P=.009). In contrast, the specificity was higher for the D-VILI interpretations (56.4%; 95% CI 38.3-72.9) than for the D-VIA interpretations (50.4%; 95% CI 35.9-64.8; P=.005).ConclusionSmartphone-based image for triage of HPV-positive women is more accurate for detecting CIN2+ lesions with D-VIA than D-VILI, although with a small loss of specificity.

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Use of Smartphones as Adjuvant Tools for Cervical Cancer Screening in Low-Resource Settings

Abstract: Smartphone images may be a useful adjunct to conventional VIA and VILI for the detection of CIN2+ and improve cervical cancer screening in low-resource settings.

Cited by 45 publications

References 12 publications

Social Media and Mobile Technology for Cancer Prevention and Treatment

Social Media and Mobile Technology for Cancer Prevention and Treatment

Colposcopy telemedicine: live versus static swede score and accuracy in detecting CIN2+, a cross-sectional pilot study

A Smartphone-Based Approach for Triage of Human Papillomavirus-Positive Sub-Saharan African Women: A Prospective Study

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