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PERFORMANCE OF SMARTPHONE-BASED DIGITAL IMAGES FOR CERVICAL CANCER SCREENING IN A LOW-RESOURCE CONTEXT

Published online by Cambridge University Press:  20 June 2018

Phuong Lien Tran Open the ORCID record for Phuong Lien Tran [Opens in a new window] ,
Caroline Benski ,
Manuela Viviano ,
Patrick Petignat ,
Christophe Combescure ,
Jeromine Jinoro ,
Josea Lea Herinianasolo  and
Pierre Vassilakos
Phuong Lien Tran
Affiliation:
Gynecology Division, Department of Gynecology and Obstetrics, Geneva University [email protected]
Caroline Benski
Affiliation:
Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Saint Damien Healthcare Centre
Manuela Viviano
Affiliation:
Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals
Patrick Petignat
Affiliation:
Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals
Christophe Combescure
Affiliation:
Division of Clinical Epidemiology, Geneva University Hospitals
Jeromine Jinoro
Affiliation:
Saint Damien Healthcare Centre
Josea Lea Herinianasolo
Affiliation:
Saint Damien Healthcare Centre
Pierre Vassilakos
Affiliation:
Geneva Foundation for Medical Education and Research
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Abstract

Objectives:

Colposcopes are expensive, heavy, and need specialized technical service, which may outreach the capacity of low-resource settings. Our aim was to assess the performance of smartphone-based digital images for the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+).

Methods:

Human papillomavirus (HPV)-positive women recruited through a cervical cancer screening campaign had VIA/VILI assessment (visual inspection after application of acetic acid/lugol's iodine). Cervical digital images were captured with a smartphone camera, randomly coded with no prior selection and distributed on an online database (Google Forms) for evaluation. Healthcare providers were invited to evaluate the images and identify CIN2+. The gold standard was the histopathological diagnosis. The sensitivity and specificity for the detection of CIN2+ was assessed for each reader and reported with the 95 percent confidence interval (Clopper-Pearson method).

Results:

One hundred twenty-five consecutive HPV-positive women were included, with 19 CIN2+ (15.2 percent). Forty-five gynecologists completed the assessment, one-third were considered as experts (>50 colposcopies) and two-thirds as novices (<50 colposcopies). The sensitivity and specificity for CIN 2+ detection was 71.3 percent (67.0–75.7 percent) and 62.4 percent (57.5–67.4 percent), respectively. The performance of novices and experts was similar. The readers assessed 73.1 percent of images as acceptable for diagnostic.

Conclusion:

Smartphone-based digital images, with its high portability, have a great potential for the diagnosis of CIN2+ in low-resource context.

Keywords

SensitivitySpecificityDigital imagesSmartphoneCervical cancer
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 3 , 2018 , pp. 337 - 342
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

Financial support: This study received no specific grant from any funding agency, commercial or not-for-profit sectors.

References

REFERENCES

1.Ferlay, J, Soerjomataram, I, Dikshit, R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386.Google Scholar
2.Practice Bulletin No. 157: Cervical Cancer Screening and Prevention. Obstet Gynecol. 2016;127:e1–e20.Google Scholar
3.World Health Organization. Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. WHO guidelines. http://www.who.int/reproductivehealth/publications/cancers/screening_and_treatment_of_precancerous_lesions/en/ (accessed December 29, 2016).Google Scholar
4.Catarino, R, Vassilakos, P, Jinoro, J, et al. Human papillomavirus prevalence and type-specific distribution of high- and low-risk genotypes among Malagasy women living in urban and rural areas. Cancer Epidemiol. 2016;42:159–166.Google Scholar
5.Wagner, RF, Metz, CE, Campbell, G. Assessment of medical imaging systems and computer aids: A tutorial review. Acad Radiol. 2007;14:723–748.Google Scholar
6.Gallas, BD, Pennello, GA, Myers, KJ. Multireader multicase variance analysis for binary data. J Opt Soc Am A Opt Image Sci Vis. 2007;24:B70–B80.Google Scholar
7.LaFleur, BJ, Greevy, RA. Introduction to permutation and resampling-based hypothesis tests. J Clin Child Adolesc Psychol. 2009;38:286–294.Google Scholar
8.Schadel, D, Coumbos, A, Ey, S, et al. Evaluation of a digital store-and-forward colposcopic system--A pilot study to assess usability for telemedicine. J Telemed Telecare. 2005;11:103–107.Google Scholar
9.Ferris, DG, Litaker, MS, ASCUS/LSIL Triage Study (ALTS) Group. Colposcopy quality control by remote review of digitized colposcopic images. Am J Obstet Gynecol. 2004;191:1934–1941.Google Scholar
10.Liu, AH, Gold, MA, Schiffman, M, et al. Comparison of colposcopic impression based on live colposcopy and evaluation of static digital images. J Low Genit Tract Dis. 2016;20:154–161.Google Scholar
11.Apgar, BS, Kittendorf, AL, Bettcher, CM, et al. Update on ASCCP consensus guidelines for abnormal cervical screening tests and cervical histology. Am Fam Physician. 2009;80:147–155.Google Scholar
12.Isidean, SD, Mayrand, MH, Ramanakumar, AV, et al. Comparison of triage strategies for HPV-positive women: Canadian Cervical Cancer Screening Trial Results. Cancer Epidemiol Biomarkers Prev. 2017;26:923–929.Google Scholar
13.Fokom-Domgue, J, Combescure, C, Fokom-Defo, V, et al. Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: Systematic review and meta-analysis of diagnostic test accuracy studies. BMJ. 2015;351:h3084.Google Scholar
14.Shastri, SS, Dinshaw, K, Amin, G, et al. Concurrent evaluation of visual, cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai, India. Bull World Health Organ. 2005;83:186–194.Google Scholar
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