Low-cost Mobile Oral Cancer Screening for Low Resource Setting

资源匮乏的低成本移动口腔癌筛查

• 批准号: 9762395
• 负责人: Rongguang Liang
• 金额: $ 92.26万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-19 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9762395
• 关键词: Accounting; Acute; Address; Adherence; Algorithms; Cancer Center; Car Phone; Cellular Phone; Chronic; Clinical; Collaborations; Computer software; Dental; Detection; Device Designs; Devices; Diagnosis; Diagnostic; Disease Progression; Early Diagnosis; Engineering; Evidence based intervention; FDA approved; Feedback; Goals; Health; Health Care Costs; Health Expenditures; Health Personnel; Healthcare; Human papilloma virus infection; Image; Imaging Device; Incidence; India; Individual; Instruction; International; Lesion; Light; Malignant - descriptor; Malignant Neoplasms; Modality; Morbidity - disease rate; Oral; Oral Diagnosis; Oral health; Oropharyngeal Squamous Cell Carcinoma; Participant; Patient risk; Patients; Performance; Phase; Population; Populations at Risk; Premalignant; Prevention; Prevention strategy; Quality of life; Research Infrastructure; Resolution; Resources; Roswell Park Cancer Institute; Rural; Science; Screening for Oral Cancer; Site; South Asian; Southeastern Asia; Specialist; Stage at Diagnosis; Survival Rate; System; Time; Treatment outcome; Triage; Work; alpha-SNAP; base; cancer prevention; community setting; cost; diagnostic accuracy; follow-up; health care availability; health literacy; high risk; image processing; imaging modality; imaging platform; imaging probe; imaging system; improved; low and middle-income countries; malignant mouth neoplasm; medical specialties; mobile application; mortality; multidisciplinary; multimodality; novel; oncology; oral lesion; portability; prototype; public health relevance; recruit; rural area; screening; southeast Asian; tool; treatment strategy; trend; validation studies; young adult

 DESCRIPTION (provided by applicant): Oral and oropharyngeal squamous cell carcinoma (OSCC) together rank as the sixth most common cancer worldwide, accounting for approximately 400,000 new cancer cases each year. About two-thirds of these cancers occur in low- and middle-income countries (LMICs), with very high rates in South and South-East Asian. While the 5-year survival rate in the U.S. for OSCC is 62%, the survival rate is only 10-40% and the cure rate around 30% in the developing world. Low survival rate is primarily attributed to the delay in diagnosis and the resultant progression of disease to an advanced stage at diagnosis. This problem is more acute in LMICs where least amount of resources is available for health care expenditure. Diagnosis is often delayed in marginalized at-risk populations living in rural areas with poor access to specialty health care, low health literacy, and problematic adherence to follow up. Early diagnosis offers the best chance to improved treatment outcomes and survival for an individual diagnosed with OSCC. Diagnosis of early oral lesions requires effective screening of the population. It is also important to detect and diagnose the chronic and malignant oral lesions, so efficient prevention and treatment strategies can be devised. We propose a mobile intra-oral imaging device and image platform to address the urgent need of a low-cost, portable, easy to use, and reliable imaging device for oral cancer screening in low resource settings. To achieve this goal, we have formed an international, multidisciplinary team with complementary expertise in engineering, oncology, and manufacturing/distribution. We have one of the largest cancer centers (Mazumdar- Shaw Cancer Center (MSCC), India) in LMIC to demonstrate the functionalities and validate clinical performance of the proposed device for oral cancer screening in low resource settings. We also have a collaboration with one of the largest dental companies (Carestream Health Inc) in the world to fabricate and distribute the products. We will develop prototypes in the UH2 Phase and demonstrate the functionalities and suitability in low resource setting at Roswell Park Cancer Institute and MSCC. In the UH3 Phase, we will refine the mobile intra-oral imaging device, and validate the clinical usefulness in four rural districts in Bangalore. This project is significant because early diagnosis of oral lesins and timely patient referral to specialists can reduce disease progression, reduce morbidity and mortality, and cut healthcare costs. We expect that use of this mobile based dual-modality screening approach for early diagnosis of oral cancers in community settings will eventually improve detection rates, treatment outcomes, and quality of life of patients.

 描述（由申请人提供）：口腔和口咽鳞状细胞癌 (OSCC) 一起被列为全球第六大常见癌症，每年新增约 400,000 例癌症病例。这些癌症中约三分之二发生在低收入和中等收入国家 (LMIC)，其中南亚和东南亚的发病率非常高。美国 OSCC 的 5 年生存率为 62%，而发展中国家的生存率仅为 10-40%，治愈率约为 30%。低生存率主要归因于诊断延迟以及诊断时疾病进展至晚期。这个问题在中低收入国家更为严重，因为这些国家可用于医疗保健支出的资源最少。生活在农村地区的边缘化高危人群难以获得专业医疗保健、健康素养较低且难以坚持随访，因此诊​​断往往会被延迟。早期诊断为诊断患有 OSCC 的个体提供了改善治疗结果和生存的最佳机会。早期口腔病变的诊断需要对人群进行有效的筛查。检测和诊断慢性和恶性口腔病变也很重要，因此可以制定有效的预防和治疗策略。我们提出了一种移动口腔内成像设备和图像平台，以满足资源匮乏环境下口腔癌筛查对低成本、便携式、易于使用且可靠的成像设备的迫切需求。为了实现这一目标，我们组建了一支国际化的多学科团队，在工程、肿瘤学和制造/分销方面拥有互补的专业知识。我们拥有中低收入国家最大的癌症中心之一（印度 Mazumdar-Shaw 癌症中心 (MSCC)），用于展示拟议设备在资源匮乏环境中进行口腔癌筛查的功能并验证其临床性能。我们还与世界上最大的牙科公司之一 (Carestream Health Inc) 合作制造和分销这些产品。我们将在 UH2 阶段开发原型，并在罗斯威尔帕克癌症研究所和 MSCC 的低资源环境中展示其功能和适用性。在UH3阶段，我们将完善移动口腔内成像设备，并验证其临床实用性 班加罗尔的四个农村地区。该项目意义重大，因为口腔Lesins的早期诊断和及时将患者转诊给专家可以减少疾病进展，降低发病率和死亡率，并降低医疗费用。我们预计，在社区环境中使用这种基于移动设备的双模态筛查方法进行口腔癌的早期诊断将最终提高检出率、治疗结果和患者的生活质量。