Removing the Screening Barrier: The Callascope

The speculum (left) has long been used for cervical exams; the Callascope (right) is designed to improve comfort and accessibility

Cervical cancer is one of the few cancers that is largely preventable. Screening can detect early, pre-cancerous changes long before they become life-threatening. Yet hundreds of thousands of people still die from the disease each year, largely because screening never happens.

Improving outcomes requires more than effective diagnostics. It requires care that people are willing and able to engage in.

For many patients, a routine gynecology exam is something they associate with anxiety or fear and often avoid altogether. The experience of the exam itself is a major factor: discomfort and a sense of vulnerability can shape whether someone returns for care.

For decades, cervical screening has relied on the same basic tool, the speculum. It is inserted into the vaginal canal and expanded to allow visualization of the cervix. While it remains widely used, it is also a source of discomfort for many patients and a commonly cited reason for avoiding follow-up care. For individuals with a history of trauma, for trans and nonbinary patients, or for those navigating cultural expectations around modesty, the exam experience can be a deciding factor in whether screening occurs at all.

Missed screenings carry real consequences. They represent missed opportunities to detect disease early, when treatment is simpler and more effective.

A very different experience has emerged through the Callascope, a device developed by the Duke Center for Global Women’s Health Technologies (GWHT), an interdisciplinary center focused on translating engineering, clinical research, and global health innovation into real-world impact. As one participant described it, using the Callascope was “a stunning experience… I got to know my inner body.”

Using the Callascope in early clinical studies, participants reported little to no pain during the exam, and nearly all expressed a preference for the Callascope over the traditional speculum (read the full 2020 survey results here).

A Different Starting Point

The Callascope’s compact design enables imaging without the need for expansion, contributing to improved patient comfort

Too often, medical device design centers on function alone, with less attention to how tools are experience by patients or how that experience shapes engagement with care.

The Callascope addresses patient needs through design and usability. It has a smaller, more flexible form, with a slender, patient-friendly shape and a calla lily-inspired tip that guides the cervix into view without expanding the vaginal canal. An integrated camera and light source allow for direct imaging, and a built-in atomizer enables contrast application without requiring removal and reinsertion.

The result is a screening experience that is more comfortable while maintaining clinical utility.

In early studies, the Callascope captured images comparable to standard colposcopy, allowing clinicians to identify areas of concern while significantly improving patient-reported comfort. 

The Callascope also expands the role of the patient in the screening process. Without the need for a speculum, screenings can potentially be performed outside of a traditional clinical setting, including at home. While further validation and regulatory pathways are needed, this approach offers greater privacy, increased control, and the possibility of completing screening without the logistical barriers of scheduling and attending a clinical visit.

This approach is particularly relevant in settings where access is limited and where there are increased barriers to follow-up appointments. The Callascope is part of GWHT’s broader approach to developing and deploying technologies that move from design to clinical validation and real-world implementation in diverse care settings globally. Implementation efforts include integration into existing clinical workflows and training of providers to support sustainable adoption.

Reimagining the Experience of Care

The Callascope is a small device, but it reflects a broader rethinking of how care is designed and delivered.

It highlights that discomfort in cervical screening is not inevitable; it is shaped by the tools we use and the way care is structured.

It also raises a practical question: if a clinically effective tool discourages patients from returning, how effective is it in practice?

Widespread adoption will require training, integration into existing workflows, and trust from both patients and providers. Ongoing research will help clarify how the device performs across different populations and how it fits within current screening guidelines.

In parallel to the development and deployment of the Callascope, GWHT is developing AI-based methods to support interpretation of cervical images, creating a combined device and decision-support system aimed at improving detection and clinical decision-making. In the coming weeks, we will explore how these approaches can further expand access to effective screening across diverse clinical settings.

A nurse practices use of the Callascope with a tablet on a mannequin in a clinic in Ghana.