A feasibility study of upcycled smartphone-based colposcopy for visual inspection of cervix performed by community healthcare workers in rural Vietnam

Le résumé fourni par la source

Objective: To assess the feasibility of smartphone-based colposcopy for cervical cancer screening, when utilized by the community healthcare workers of rural Vietnam.Methods: Women in community villages of rural Vietnam were enrolled for a cervical cancer screening project.Cervical images were obtained by pre-trained community healthcare workers using a portable, upcycled smartphone-based colposcopy (Samsung Galaxy Note 20).Images were taken before and after the visualization after acetic acid (VIA) and concomitant Papanicolaou smear was done when feasible.Images were later reviewed independently by 2 experienced gynecologists.Image quality and kappa statistics were assessed for the measurement of agreement in VIA findings.Results: Among 476 women screened, images of 177 cases obtained between July and August 2020 were analyzed.The median age of women was 43 years (range 20-63).The entire cervix was visible in 86.4% and unsatisfactory colposcopy findings were 16.4%.The kappa statistic for interobserver reliability was 0.61 for VIA positivity, indicating substantial agreement.Image clarity was rated from 1 to 5 (1=very poor, 5=excellent), with 77.3% assessed as 'average' and above.The reasons for the image quality to be rated average or less were poor image focus (15.3%), inadequate squamocolumnar junction visibility (18%), obscuring of the transformation zone due to blood (11.3%), discharge (14.7%), or artifacts such as intrauterine device or polyps (5.1%). Conclusion:The usage of smartphone-based colposcopy was feasible with an adequate agreement between the VIA assessment based on the captured images when performed by pre-trained healthcare workers in low-resource settings.

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