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Novel see and treat strategies for cervical cancer prevention in low-resource settings

在资源匮乏地区预防宫颈癌的新颖的观察和治疗策略

基本信息

批准号：
10609010
负责人：
DAVID Frank KATZ
金额：
$ 61.07万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-02-01 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10609010
关键词：
Ablation Academic Medical Centers Acetic Acids Address Algorithms Archives Biopsy Blinded Blood Vessels Cardiomyopathies Caring Cause of Death Cellulose Cervical Cervical Cancer Screening Cervix Uteri Cessation of life Clinic Clinical Clinical Research Cold Therapy Colposcopes Colposcopy Contrast Media Country Coupled Decision Making Devices Diagnosis Disease Disinfection Electrocoagulation Ensure Environment Ethanol Excision Exposure to Family suidae Fluorescein Food Additives Funding Gel Goals Health Resources Health care facility Human Image Income Injections Intervention Iodine Lesion Lighting Local Therapy Malignant Neoplasms Malignant neoplasm of cervix uteri Methods Microscope Microscopic Modeling Output Pathology Patients Physicians Procedures Process Protocols documentation Provider Public Health Quality Control Research Resource-limited setting Resources Screening Result Sensitivity and Specificity Silicones Site Solid Neoplasm Source Speculums Stains Systemic Therapy Technology Testing Therapeutic Therapeutic Agents Tissues Treatment Efficacy Vagina Vision Visualization Water Woman Work aqueous automated algorithm cervical biopsy cervical cancer prevention clinical development clinical diagnosis contrast enhanced cost design diagnostic value experience improved in vivo innovation intelligent algorithm intervention cost large scale production loop electrosurgical excision procedure low and middle-income countries medically underserved mortality novel portability preference premalignant safety assessment screening tv watching underserved area user-friendly volunteer

项目摘要

Cervical cancer is the second leading cause of death for women worldwide; 85% of deaths occur in low and middle- income countries (LMICs), despite the fact that well-established interventions exist for pre-invasive disease. In the U.S., screening for cervical cancer is performed with the Papanicolaou (Pap) smear. Colposcopy, which visualizes the acetic acid stained cervix with a low power microscope, followed by biopsy of cervical abnormalities, serves as a confirmatory test for women with positive screening results. Women with pre-cancer are treated via excision of a portion of the cervix using Loop Electrosurgical Excision Procedure (LEEP). Women with cancer are referred to a combination of local and/or systemic therapy depending on the stage of invasive disease. This model is not practical to implement in medically-underserved regions due to lack of resources to procure, implement, and maintain the technologies in the care cascade. Thus, alternative protocols that employ low-cost, simple-to-use technologies are needed to mitigate cervical cancer. Our vision is to develop high quality, low-cost interventions that will be effective in low-resource health facilities to address shortcomings of current technological solutions to cervical cancer prevention. This vision requires 3 distinct innovations: 1) an ultra-portable visualization device coupled with routinely used contrast agents to reduce discomfort, enable visualization of microscopic disease, and provide quality control through image review and archiving (Aim 1); 2) enhanced contrast and smart algorithms to reduce unnecessary referrals or treatment of screen positive women (in the absence of confirmatory biopsy) (Aim 2); and 3) a low-cost therapeutic that is as effective as current ablative approaches but more readily accessible to treat pre-invasive disease (Aim 3). These innovations build upon: 1) a novel Pocket colposcope developed under previous funding that enables portable colposcopy of the cervix; and 2) preliminary results that support these new innovations.

宫颈癌是全世界妇女死亡的第二大原因；85%的死亡发生在中低档

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Radiologic-pathologic analysis of increased ethanol localization and ablative extent achieved by ethyl cellulose.

DOI：
10.1038/s41598-021-99985-4
发表时间：
2021-10-19
期刊：
Scientific reports
影响因子：
4.6
作者：
Chelales E;Morhard R;Nief C;Crouch B;Everitt JI;Sag AA;Ramanujam N
通讯作者：
Ramanujam N

In Vivo Evaluation of Safety and Efficacy of Ethyl Cellulose-Ethanol Tissue Ablation in a Swine Cervix Model.

DOI：
10.3390/bioengineering10111246
发表时间：
2023-10-25
期刊：
Bioengineering (Basel, Switzerland)
影响因子：
0
作者：
通讯作者：

A novel speculum-free imaging strategy for visualization of the internal female lower reproductive system.

DOI：
10.1038/s41598-020-72219-9
发表时间：
2020-10-06
期刊：
Scientific reports
影响因子：
4.6
作者：
Asiedu MN;Agudogo JS;Dotson ME;Skerrett E;Krieger MS;Lam CT;Agyei D;Amewu J;Asah-Opoku K;Huchko M;Schmitt JW;Samba A;Srofenyoh E;Ramanujam N
通讯作者：
Ramanujam N

Optimizing ethyl cellulose-ethanol delivery towards enabling ablation of cervical dysplasia.

DOI：
10.1038/s41598-021-96223-9
发表时间：
2021-08-19
期刊：
Scientific reports
影响因子：
4.6
作者：
Mueller JL;Morhard R;DeSoto M;Chelales E;Yang J;Nief C;Crouch B;Everitt J;Previs R;Katz D;Ramanujam N
通讯作者：
Ramanujam N

Targeting Tumor Acidosis and Regulatory T Cells Unmasks Anti-Metastatic Potential of Local Tumor Ablation in Triple-Negative Breast Cancer.