Cervical Health For A Lifetime – The Indian Smart Scope Innovation As A Key Tool For Early Cancer Detection Geneva Health Forum 2020 15/11/2020 • Svĕt Lustig Vijay Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Smart Scope cervical cancer screening campaign in rural India Second in a series – On Wednesday, 18 November, at 2pm CET, leading experts at the Geneva Health Forum (GHF) 2020 will provide their take on how to move forward on the recently approved WHO global strategy to accelerate the elimination of cervical cancer, which kills 300,000 women every year, mostly in low-resource settings like India. The Indian-made Smart Scope, which will be featured at the Forum’s virtual Innovation Fair, could be a key tool in the battle to put an end to cervical cancer. The Smart Scope can detect cervical cancer in less than ten minutes, making it ideal for mass screening programmes in rural settings. The innovation fair, which will run from from Monday to Wednesday between 12:00-12:30, is open to all GHF attendees to chat with innovators about their products. Cervical cancer is deadliest in low- and middle-income countries. In India alone, cervical cancer claims the lives of 100,000 women a year, making it the second largest killer of women in the country after breast cancer. Unlike other countries that have set up an organized cervical cancer screening strategy and mass-vaccination against Human Papilloma Virus (HPV), India has remained largely silent on the issue, noted a recent study by the University of Nebraska. “There is no organized cervical cancer screening programme and no national policy for HPV prevention in India – screening of asymptomatic females is practically non-existent,” warned researchers. In 2020, HPV vaccine coverage in India is still low, and prices are out of reach for the average Indian, at $160 for three doses, according to researchers at the University of Nebraska. Mass screening for cervical cancer is another issue. The most commonly used test, the pap-smear test, is invasive, requires significant expertise to analyze, and out-of-reach for rural Indians, who account for two-thirds of India’s overall population. Even if women from rural settings are able to reach distant clinics to get their pap-smear, the test takes four to five days to be processed. As a result, many women do not return for follow-up because they cannot afford to take another day off from work. Periwinkle Technologies, a company based in Pune, India and supported by the nation’s Department of Biotechnology, offers a practical, portable and affordable solution to detect cervical cancer in a single visit – the ‘Smart Scope’. The Smart Scope is an affordable handheld device that can be linked to a tablet The Smart Scope is a non-invasive pencil device that can detect cervical abnormalities in less than ten minutes, with the aid of a tablet and an intuitive app. The test result is color-coded and supplemented by a visual report. Users find it “extremely” easy to use and to interpret, says Veena Moktali, founder of Periwinkle Technologies. Given the device does not require specialized equipment or electricity, it can reach rural communities, especially during mass-screening programmes, which form a cornerstone of the country’s health promotion strategy. In one day, the Smart Scope can screen up to 60 women, says Moktali. The AI-powered Smart Scope diagnoses cervical cancer with a sensitivity of 80 to 85 per cent, which is almost double that of the pap-smear test in some cases – where laboratory equipment or expertise may be spotty. Smart Scope Campaign in Indian clinic Since March 2019, over a hundred Smart Scopes have been installed in healthcare facilities in various states across India. Together, they have screened more than 5,000 women, of which 5% had precancerous cervical conditions and 30% had benign HPV infections, according to an impact analysis by Periwinkle Technologies, the Tata Memorial Center as well as Deenanath Mangeshkar Hospital. A study of the device’s efficacy has been accepted for publication by Asian Pacific Journal of Cancer Prevention (APJCP). Earlier this year, the Smart Scope won the Startup Grand Challenge competition organized by the National Health Authority. Last month, the government began a market access programme to expand the Smart Scope’s reach. But the Smartscope is much more than a cancer-detection tool. Rather, it offers women a comprehensive assessment of their cervical health because it can distinguish between pre-cancerous cells, cancerous cells, various types of infection, or even other benign abnormalities. In contrast, a pap-smear provides a limited result that is either “normal”, “unclear” or “abnormal”. The visual aspect of the report enables patients to see their diagnosis with their own eyes, lending the result more credibility, adds Dr. Varsha Singh, who is the Head of Clinical Studies and Institutional Partnership Programs at Periwinkle Technologies. In contrast, the pap smear’s “text-only” result is rather difficult to communicate to patients, and is even ignored in some cases. With the aid of a visual report, women can also show their results to family members, which is crucial for a disease that is poorly understood and deemed to lead to extra expenses for households. As a result, the Smart Scope is more likely to bring women back for follow-up and treatment than the pap-smear. Why The Smart Scope Works Technicians have screened more than 5000 women in India with the Smart Scope During the design of the Smart Scope, Periwinkle Technologies quickly understood that the speed of diagnosis was essential to their product’s success. Busy doctors, especially in rural regions, were often “very reluctant” to spend time sterilizing medical equipment through a lengthy process called autoclaving, which can take up to 45 minutes. And during mass-screenings, women seemed unwilling to get tested when procedures were time-consuming or required a second follow-up visit to get their results. “When we used to work with the doctors in rural settings, we saw that autoclaving medical equipment was a big hurdle during mass-screening camps,” says Dr. Singh. “ In addition, patients were reluctant to come for screening as it requires a second visit to get the report. Thus, it was from users’ feedback that we found that there is a requirement to do the testing very efficiently and quickly.” In response, Periwinkle Technologies designed a disposable sleeve that lies between the Smart Scope’s camera and a patient’s cervix. This allowed doctors to quickly dispose of the sheets between consultations, and to serve as many women as possible without the need for a lengthy sterilization process like autoclaving. Although the Smart Scope’s makers are technology providers, they are also heavily focused on outreach to improve awareness of cervical cancer and to fight stigma, in collaboration with local partners. As well as having launched their own blog on gynecological health, Periwinkle Technologies regularly host training sessions, workshops, conferences and online courses for gynecologists, physicians, nurses as well as midwives. So far, 45 training sessions have been conducted, with 50 to 200 participants at each session. During their outreach, Periwinkle Technologies frame the Smart Scope very carefully. Instead of describing it as a cancer screening device, it is introduced as a tool that ensures cervical health – as any mention of cancer usually scares people away, says Moktali. Link here to register for the Geneva Health Forum and join the Virtual Innovation Fair -Veena Moktali and Dr. Varsha Singh contributed to this story. Image Credits: Periwinkle Technologies, The Lancet. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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