Low-cost Mobile Oral Cancer Screening for Low Resource Setting

 描述(申请人提供)：口腔和口咽鳞状细胞癌(OSCC)是全球第六大最常见的癌症，每年约有40万新的癌症病例。其中约三分之二的癌症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。在美国，口腔鳞状细胞癌的5年存活率为62%，而在发展中国家，其存活率仅为10%-40%，治愈率约为30%。低存活率主要归因于诊断的延迟以及由此导致的疾病进展到诊断的晚期。这个问题在可用于医疗保健支出的资源最少的LMIC中更为严重。在生活在农村地区的边缘化高危人群中，诊断往往被延误，这些人很难获得专门的卫生保健，健康素养较低，对后续行动的坚持也有问题。对于被诊断为口腔鳞状细胞癌的患者，早期诊断提供了改善治疗结果和生存的最佳机会。早期口腔损伤的诊断需要对人群进行有效的筛查。检测和诊断口腔慢性和恶性病变也很重要，以便制定有效的预防和治疗策略。我们提出了一种移动式口腔内成像设备和图像平台，以满足在低资源环境下对低成本、便携式、易用和可靠的口腔癌筛查设备的迫切需求。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)，以演示建议的口腔癌筛查设备的功能并验证其在低资源环境下的临床性能。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Roswell Park癌症研究所和MSCC展示其在低资源环境下的功能性和适用性。在UH3阶段，我们将改进移动口腔内成像设备，并验证其在 班加罗尔的四个农村地区。该项目意义重大，因为早期诊断口腔内毒素和及时将患者转介给专家可以减缓疾病进展，降低发病率和死亡率，并降低医疗成本。我们预计，在社区环境中使用这种基于移动的双模式筛查方法来早期诊断口腔癌，最终将提高患者的发现率、治疗结果和生活质量。

 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.