By Hamdy Inusah
Cervical cancer, formally defined as any kind of cancer originating from the cervix, is the fourth most common cancer among women, according to the WHO. In fact, in 2022 alone, The American Cancer Society estimates that around 14,100 new cases of cervical cancer will be diagnosed with cervical cancer and 4,280 people worldwide will die from the disease. North Carolina, in fact, has one of the highest numbers of new cancer diagnoses and cancer deaths when compared to the rest of the states in the US.
While all exact causes of cervical cancer are uncertain, it is known that long-lasting infection with certain types of human papillomavirus (HPV, a sexually transmitted disease) is the main cause. Other risk factors that can contribute to cervical cancer include having a weakened immune system, smoking, and/or other sexually transmitted infections.
Early stage cervical cancer has generally no signs or symptoms, but advanced stage cervical
cancer can be characterized by symptoms such as vaginal bleeding after intercourse, between periods, and/or after menopause; uncharacteristically watery or bloody discharge; and vaginal pain, among others. Because symptoms only appear in late stage cervical cancer, early detection is imperative but can also prove to be quite difficult. Routine pap smears and screening tests are the recommended methods for prevention and detection, along with the HPV vaccine, but women living in low and middle income cities and countries might not have the resources or facilities to properly combat cervical cancer.
In order to combat this issue, researchers within the Center for Global Women’s Health Technologies (GWHT) at Duke University developed the Callascope, a low-cost medical device designed to allow its user to visualize and image capture their cervix without clinician assistance. This device solves a number of issues with accessing healthcare resources by combating the lack of accessible health facilities and fear of traditional medical devices, among other issues, as well as serving to increase the empowerment of women in these areas by increasing confidence and knowledge in and about one’s body, along with a greater willingness to look more into one’s reproductive health. The Callascope can also pave the way for other medical devices that could be used at home to help detect and combat other diseases.
Researchers at GWHT recently reported our feasibility testing in Ventanilla, Peru, along with community-health volunteers in the Journal of Women’s Health and Reproductive Medicine. Our studies found that while there was some initial hesitancy at the beginning of the study, most women involved in the trial not only reported no sense of discomfort while using the Callascope, some even noted that it was preferable to the standard exam with a traditional speculum. One user even reported that she previously had “very bad experience[s] with the speculum in the hospitals where I’ve had them [exams] done with pain or burning,” but also reported that the Callascope “felt very good and [she] didn’t feel anything.” Both the traditional speculum and the Callascope with their components can be seen in Figure 1 and 2 from the manuscript.
Additionally, studies were also done in Durham, North Carolina, in order to see the device applied at a wider scale. In our recent article in the Journal of Women’s Health and Gynecology, we showed the use of the Callascope in both a clinical setting as an alternative to the traditional speculum, as well as the at-home setting previously mentioned in the Ventanilla study. Reports found that after proper instruction, most participants found the Callascope both easy to use and comfortable when performing their personal screenings, and future studies hope to work with more health centers and minority advocacy groups in order to see the response to the device from a more diverse group of participants as well as perform more studies in low and middle income communities.
Finally, in response to greater rates of detection due to devices such as the Callascope as well as overall awareness of cervical cancer, treatment options such as surgery, chemotherapy, radiation, and complementary medicine can be more widely and properly used to combat this disease.