; 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.
|Nghiem, Van T; Davies, Kalatu R; Beck, J Robert et al. (2016) Overtreatment and Cost-Effectiveness of the See-and-Treat Strategy for Managing Cervical Precancer. Cancer Epidemiol Biomarkers Prev 25:807-14|
|Nghiem, Van T; Davies, Kalatu R; Chan, Wenyaw et al. (2016) Disparities in cervical cancer survival among Asian-American women. Ann Epidemiol 26:28-35|
|Yamal, Jose-Miguel; Guillaud, Martial; Atkinson, E Neely et al. (2015) Prediction using hierarchical data: Applications for automated detection of cervical cancer. Stat Anal Data Min 8:65-74|
|Montealegre, Jane R; Landgren, Rachel M; Anderson, Matthew L et al. (2015) Acceptability of self-sample human papillomavirus testing among medically underserved women visiting the emergency department. Gynecol Oncol 138:317-22|
|Nghiem, V T; Davies, K R; Beck, J R et al. (2015) Economic evaluation of DNA ploidy analysis vs liquid-based cytology for cervical screening. Br J Cancer 112:1951-7|
|Sheikhzadeh, Fahime; Ward, Rabab K; Carraro, Anita et al. (2015) Quantification of confocal fluorescence microscopy for the detection of cervical intraepithelial neoplasia. Biomed Eng Online 14:96|
|Davies, Kalatu R; Cantor, Scott B; Cox, Dennis D et al. (2015) An alternative approach for estimating the accuracy of colposcopy in detecting cervical precancer. PLoS One 10:e0126573|
|Li, Gerald; van Niekerk, Dirk; Miller, Dianne et al. (2014) Molecular fixative enables expression microarray analysis of microdissected clinical cervical specimens. Exp Mol Pathol 96:168-77|
|Wang, Lu; Lee, Jong Soo; Lane, Pierre et al. (2014) A statistical model for removing inter-device differences in spectroscopy. Opt Express 22:7617-24|
|Scheurer, Michael E; Danysh, Heather E; Follen, Michele et al. (2014) Association of traffic-related hazardous air pollutants and cervical dysplasia in an urban multiethnic population: a cross-sectional study. Environ Health 13:52|
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