; This Program Project uses the rigorous paradigm of technology assessment to evaluate optical technologies and molecular imaging for the screening and diagnosis of cervical cancer. We will identify opportunities in which technology could improve outcomes, decrease costs, and replace infrastructure. Optical measurement of tissue provides quantitative information that can be analyzed, instantaneously producing an objective diagnosis even in the hands of a non-expert operator. We will conduct multi-center clinical trials to assess the screening and diagnostic potential of several emerging technologies: a fluorescence/reflectance point probe, a multispectral digital colposcope, confocal micrsoscopy, and new contrast agents to mark cervical lesions that may be used in combination with other devices. This Program Project will also develop and evaluate a system that combines a point probe with multispectral imaging, and we will create low-cost, portable imaging devices that are optimized to meet healthcare needs in the developing world and underserved areas of the United States. Specifically, we will measure the sensitivity, specificity, cost-effectiveness, degree of patient discomfort, time-to-result, and training requirements associated with new instruments and techniques. We will compare these systems to the standard-of-care and to each other to find optimized solutions for low- and high-resource settings. We maintain a pipeline of innovation that brings devices from the laboratory bench to the bedside. Although new HPV vaccines may eventually have a strong impact on cervical cancer incidence, the biological limitations of current vaccines and the logistical difficulty associated with universal mass vaccination programs mean that early detection will remain our best defense against cervical cancer for the forseeable future.
Cervical cancer is a large cause of cancer mortality in the developing world, and continues to be a problem of cost-effectiveness and follow-up adherence in the developed world. Improvements in technology for screening and diagnosis can reduce costs and improve patient satisfaction in the developed world, and help create new cancer detection initiatives in low-resource, high-risk populations.
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|Montealegre, Jane R; Zhou, Renke; Amirian, E Susan et al. (2014) Uncovering nativity disparities in cancer patterns: Multiple imputation strategy to handle missing nativity data in the Surveillance, Epidemiology, and End Results data file. Cancer 120:1203-11|
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|Montealegre, Jane R; Zhou, Renke; Amirian, E Susan et al. (2013) Nativity disparities in late-stage diagnosis and cause-specific survival among Hispanic women with invasive cervical cancer: an analysis of Surveillance, Epidemiology, and End Results data. Cancer Causes Control 24:1985-94|
|Yang, Jingjing; Scott, David W (2013) Robust Fitting of a Weibull Model with Optional Censoring. Comput Stat Data Anal 67:149-161|
|El Hallani, S; Poh, C F; Macaulay, C E et al. (2013) Ex vivo confocal imaging with contrast agents for the detection of oral potentially malignant lesions. Oral Oncol 49:582-90|
|Montgomery, Owen; Follen, Michele; Urdaneta-Hartmann, Sandra (2012) The 2010 Annual Sex and Gender Research Forum at Drexel University and Drexel University College of Medicine: an institute for women's health and leadership initiative. Introduction. Gend Med 9:S1-6|
|Pham, Bryan; Rhodes, Helen; Milbourne, Andrea et al. (2012) Epidemiologic differentiation of diagnostic and screening populations for the assessment of cervical dysplasia using optical technologies. Gend Med 9:S36-47|
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