Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru.

Published

Journal Article

OBJECTIVE:Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru. DESIGN AND SETTING:Images of the cervix were captured with a standard-of-care and Pocket colposcope at la Liga Contra el Cáncer in Lima, Peru. POPULATION:Two hundred Peruvian women with abnormal cytology and/or human papillomavirus positivity were enrolled. METHODS:Images were collected using acetic acid and Lugol's iodine as contrast agents. Biopsies were taken as per standard-of-care procedures. MAIN OUTCOME MEASURES:After passing quality review, images from 129 women were sent to four physicians who provided a diagnosis for each image. RESULTS:Physician interpretation of images from the two colposcopes agreed 83.1% of the time. The average sensitivity and specificity of physician interpretation compared with pathology was similar for the Pocket (sensitivity = 71.2%, specificity = 57.5%) and standard-of-care (sensitivity = 79.8%, specificity = 56.6%) colposcopes. When compared with a previous study where only acetic acid was applied to the cervix, results indicated that adding Lugol's iodine as a secondary contrast agent improved the percent agreement between colposcopes for all pathological categories by up to 8.9% and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively. CONCLUSIONS:The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru. TWEETABLE ABSTRACT:The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.

Full Text

Duke Authors

Cited Authors

  • Mueller, JL; Lam, CT; Dahl, D; Asiedu, MN; Krieger, MS; Bellido-Fuentes, Y; Kellish, M; Peters, J; Erkanli, A; Ortiz, EJ; Muasher, LC; Taylor, PT; Schmitt, JW; Venegas, G; Ramanujam, N

Published Date

  • September 2018

Published In

Volume / Issue

  • 125 / 10

Start / End Page

  • 1321 - 1329

PubMed ID

  • 29893472

Pubmed Central ID

  • 29893472

Electronic International Standard Serial Number (EISSN)

  • 1471-0528

International Standard Serial Number (ISSN)

  • 1470-0328

Digital Object Identifier (DOI)

  • 10.1111/1471-0528.15326

Language

  • eng