scholarly journals A Novel, Versatile Speculum-free Callascope for Clinical Examination and Self-Visualization of the Cervix

2019 ◽  
Author(s):  
Mercy N. Asiedu ◽  
Júlia S. Agudogo ◽  
Mary Elizabeth Dotson ◽  
Marlee S. Krieger ◽  
John W. Schmitt ◽  
...  

AbstractBackgroundInvasive cervical cancer is preventable, yet affects 500,000 women worldwide each year, and over half these women die. Barriers to cervical cancer screening include lack of awareness of cervical cancer and the cervix, fear of the speculum, and lack of women-centric technologies. We developed a low-cost (∼$50), cervix-imaging device called the Callascope, which comprises an imaging component, camera and inserter that eliminates the need for a speculum and enables self-insertion. We sought to assess the quality of physicians’ images of the cervix using the Callascope versus the speculum in live patients and study women’s willingness to independently use the Callascope to image their cervix.MethodsWe conducted two main studies: (1) a clinical study in which a physician imaged the cervix of patients using both the speculum and Callascope in a 2×2 crossover design; and (2) home-based self-cervix imaging with the Callascope.ResultsParticipants of the clinical study (n=28) and home study (n=12) all indicated greater comfort and an overall preference for the Callascope over the speculum. The clinical study data indicated that the Callascope enabled similar visualization compared to the speculum while significantly improving patient experience. With physician insertion and manipulation, the Callascope enabled cervix visualization for 82% of participants. In the home-study, 83% of participants were able to visualize their cervix with the Callascope on the first try and 100% after multiple attempts.ConclusionThe Callascope is more comfortable and provides similar visualization to the speculum. The Callascope can be used by medical providers for clinical exams while also enabling home self-screening for cervical cancer and promoting a better understanding of one’s cervix to increase awareness of cervical screening needs. The Callascope may increase cervical cancer screening rates through reducing barriers including cost, discomfort, lack of awareness and stigma.

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 50-50
Author(s):  
Mary Elizabeth Dotson ◽  
Mercy Asiedu ◽  
Nimmi Ramanujam

PURPOSE Invasive cervical cancer is preventable, yet it affects 500,000 women worldwide each year, and more than one half these women die. Barriers to cervical cancer screening include a lack of awareness of cervical cancer and the cervix, fear of the speculum, and lack of women-centric technologies. We developed a low-cost (approximately $50), cervix-imaging device called the Callascope, which consists of an imaging component, camera, and inserter that obviates the need for a speculum and enables self-insertion. Studies are lacking regarding women’s willingness to independently image their cervix and women’s ability to effectively use the Callascope for self-imaging. METHODS We conducted two studies: in-depth interviews to assess the willingness to self-image the cervix, perceptions of the Callascope, and knowledge, attitudes, and practices toward cervical cancer screening; and home-based self-cervix imaging with the Callascope where women recorded an audio reflection on their experience. RESULTS Participants in interviews (n = 12) and home study (n = 12) all indicated a preference for the Callascope over the speculum. Interview data demonstrated that 53% of participants had little knowledge of basic reproductive anatomy, and only 17% of participants understood that human papillomavirus was a direct cause of cervical cancer. Self-exam data showed that 83% of participants were able to visualize their cervix with the Callascope on the first try and 100% were able to do so by the end of the study. Of participants, 100% indicated that the home exam was an empowering and informative experience. CONCLUSION The Callascope is more comfortable than the speculum and women are able to successfully image their cervices from home without the need for a speculum. With improved diagnostic capabilities, the Callascope could be used by medical providers for clinical exams, particularly in low-resource settings, as a low-cost and more comfortable alternative to the SOC. The Callascope enables home self-screening for cervical cancer and a better understanding of one’s body, which could make screening more accessible in low-resource settings.


Author(s):  
David Peddie

<p>In 1999, a cervical cancer screening programme was commenced in the central Pacific nation of Kiribati. This was in response to  the relatively high  incidence of  and mortality from  cervical cancer, although estimates are unclear, in this  country with its limited  resources. In Kiribati there are minimal surgical and  medical facilities available for treatment of invasive cervical cancer.  The  financial and social cost of   sending patients  to a remote destination, India or Taiwan, for surgical or radiation treatment  make a  strong   case for screening and prevention. A well organised screening programme, such as that of the New Zealand National Cervical Screening Programme,   can potentially prevent nine out of 10 invasive cancers.</p>


2015 ◽  
Vol 25 (1) ◽  
pp. 106-111 ◽  
Author(s):  
Danielle Vicus ◽  
Rinku Sutradhar ◽  
Yan Lu ◽  
Rachel Kupets ◽  
Lawrence Paszat

ObjectiveThe aim of this study was to estimate the effect of cervical screening in the prevention of invasive cervical cancer among age groups, using a population-based case-control study in the province of Ontario, Canada.MethodsExposure was defined as cervical cytology history greater than 3 months before the diagnosis date of cervical cancer (index date). Cases were women who were diagnosed with cervical cancer between January 1, 1998, and December 31, 2008. Controls were women without a diagnosis of cervical cancer on, or before, December 31, 2008. Two controls were matched to each case on year of birth and income quintile, as of the index date. Conditional logistic regression was used to estimate the odds ratio for having been screened among those with cervical cancer.ResultsCervical cancer screening performed between 3 and 36 months before the index date was protective against invasive cervical cancer in women aged 40 through 69 years. In women younger than 40 years, cervical cancer screening performed 3 to 36 months before the index date was not protective.ConclusionsCervical screening is associated with a reduced risk for invasive cervical cancer among women older than 40 years. Cervical cancer resources should be focused on maximizing the risk reduction.


2019 ◽  
Vol 1 (1) ◽  
pp. 55-65
Author(s):  
Jude Egwurugwu ◽  
S.D. Ejikunle ◽  
E.I. Dike ◽  
M.C. Ohamaeme ◽  
Jude Egwurugwu ◽  
...  

Background: Cervical cancer is the 2nd commonest cancer among women worldwide and the most common cancer among women in developing countries like Nigeria. Though preventable by screening for premalignant and early cervical lesions, this is predicated on the knowledge and practice of a cervical screening. Objective: To assess the knowledge and practice of cervical cancer screening among women in Orlu, Local Government Area(LGA) Imo State, Nigeria. Materials & Methods: A community based cross-sectional study with the use of 502 interviewer – administered questionnaires was conducted among women in Orlu LGA of Imo State. All the women in the communities attending the annual August Meeting who consented were recruited for this study. Results: The study showed that the mean age of the respondents was 42±2.8years. Furthermore, 82.3% of respondents attained postsecondary school educational level, 61.8% & 21.1% were multiparous and grand multiparous respectively. Also, 80.5% of respondents have heard about cervical cancer screening. Majority (67.5%) of these respondents heard it from health care providers. There was a positive statistically significant relationship between educational status and the likelihood of having knowledge of cervical cancer screening, (p< 0.01). The level of practice of cervical cancer screening was very low among the respondents(13.5%).Though majority of the respondents have high level of educational attainment this did not reflect their practice of cervical cancer screening. Conclusion: There was high knowledge of cervical cancer and cervical screening modalities among women in Orlu but their practice of cervical cancer screening was very low. There is an urgent need to educate and encourage women on the benefits of cervical cancer screening. Key words: cervical cancer, knowledge, Practice, Orlu women, Screening.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67,p16INK4a, BD ProEx C, and Cytoactiv HPV L1.


2018 ◽  
Vol 5 ◽  
pp. 233339361878363 ◽  
Author(s):  
Brianne Wood ◽  
Virginia L. Russell ◽  
Ziad El-Khatib ◽  
Susan McFaul ◽  
Monica Taljaard ◽  
...  

In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.


2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.


2021 ◽  
Author(s):  
Nigus Bililign Yimer ◽  
Mohammed Akibu Mohammed ◽  
Kalkidan Solomon ◽  
Mesfin Tadese ◽  
Stephanie Grutzmacher ◽  
...  

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375


2013 ◽  
Vol 8 (1) ◽  
pp. 18 ◽  
Author(s):  
Virginia L. Russell ◽  
Sarah De Leeuw

Guided by feminist and community-based participatory methodologies and by efforts to decolonize health research practices, and undertaken with qualitative research methods (interviews, open-ended questionnaires, and analysis of arts-based expressions like storytelling, journaling, and picture-making), this research identified challenges and barriers that (predominantly Aboriginal) women in northern British Columbia faced when trying to access sexual health care services related to HPV and cervical cancer screening. The research also examined the possible effectiveness of creative or arts-based strategies to promote cervical health and screening awareness among young and/or traditionally underserved or marginalized women. We review findings from data gathered over six months during multiple interactions with 22 women from a wide range of ethnic backgrounds. Results confirm that ethnicity, finances, and formal education are determinants in women’s awareness about, access to, and use of cervical screening services, and that experiences of gendered victimization, feelings of disempowerment, and life circumstances all influenced women’s comfort levels with, access to, and use of cervical cancer screening services.


Author(s):  
Esther E. Idehen ◽  
Anni Virtanen ◽  
Eero Lilja ◽  
Tomi-Pekka Tuomainen ◽  
Tellervo Korhonen ◽  
...  

Migrant-origin women are less prone to cervical screening uptake compared with host populations. This study examined cervical cancer screening participation and factors associated with it in the Finnish mass screening program during 2008–2012 in women of Russian, Somali and Kurdish origin compared with the general Finnish population (Finns) in Finland. The study population consists of samples from the Finnish Migrant Health and Well-being Study 2010–2012 and Health 2011 Survey; aged 30–64 (n = 2579). Data from the Finnish screening register linked with other population-based registry data were utilized. For statistical analysis we employed logistic regression. Age-adjusted screening participation rates were Russians 63% (95% CI: 59.9–66.6), Somalis 19% (16.4–21.6), Kurds 69% (66.6–71.1), and Finns 67% (63.3–69.8). In the multiple-adjusted model with Finns as the reference; odds ratios for screening were among Russians 0.92 (0.74–1.16), Somalis 0.16 (0.11–0.22), and Kurds 1.37 (1.02–1.83). Among all women, the substantial factor for increased screening likelihood was hospital care related to pregnancy/birth 1.73 (1.27–2.35), gynecological 2.47 (1.65–3.68), or other reasons 1.53 (1.12–2.08). Screening participation was lower among students and retirees. In conclusion, screening among the migrant-origin women varies, being significantly lowest among Somalis compared with Finns. Efforts using culturally tailored/population-specific approaches may be beneficial in increasing screening participation among women of migrant-origin.


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