Low-cost Mobile Oral Cancer Screening for Low Resource Setting

 描述（由申请人提供）：口腔和口咽鳞状细胞癌（OSCC）一起列为全球第六大常见癌症，每年约有40万例新发癌症病例。这些癌症中约有三分之二发生在低收入和中等收入国家，南亚和东南亚的发病率非常高。虽然在美国，口腔鳞状细胞癌的5年生存率为62%，但在发展中国家，生存率仅为10-40%，治愈率约为30%。低存活率主要归因于诊断延迟以及由此导致的疾病在诊断时进展到晚期。这一问题在中低收入国家更为严重，因为这些国家用于保健开支的资源最少。诊断往往是延迟边缘化的危险人群生活在农村地区，难以获得专业卫生保健，低健康素养，并有问题的坚持后续。早期诊断提供了最好的机会，以改善治疗结果和生存的个人诊断为口腔鳞状细胞癌。早期口腔病变的诊断需要对人群进行有效的筛查。口腔慢性和恶性病变的检测和诊断也很重要，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的口腔内成像设备和图像平台，以解决在低资源设置中用于口腔癌筛查的低成本、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。我们在LMIC拥有最大的癌症中心之一（Mazumdar-Shaw癌症中心（MSCC），印度），以证明在低资源环境中用于口腔癌筛查的拟议设备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，制造和分销产品。我们将在UH 2阶段开发原型，并在Roswell Park癌症研究所和MSCC的低资源环境中展示功能和适用性。在UH 3阶段，我们将完善移动的口腔内成像设备，并验证其在以下方面的临床实用性： 班加罗尔的四个农村地区。该项目意义重大，因为早期诊断口腔病变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。我们期望在社区环境中使用这种基于移动的双模态筛查方法进行口腔癌的早期诊断，最终将提高患者的检出率、治疗效果和生活质量。

 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.