Abstract
Introduction
Colposcopy-guided biopsy is the standard method to diagnose cervical pre-invasive lesions. However, standard colposcopes are expensive, require lot of space and depend on electricity for its use. A mobile version of colposcope (Gynocular) has been recently introduced which overcomes such issues. We conducted this study to evaluate the diagnostic accuracy of Gynocular for cervical intraepithelial lesions.
Materials and Methods
This cross sectional study was conducted over one year in a tertiary care referral centre in North India. Total 222 women with abnormal Pap smear were included. To avoid observer bias, Gynocular and standard colposcope examinations were performed by two different observers at different places. Patients with swede score 5 or above by standard colposcopy were subjected to biopsy. Kappa statistics was applied for analysing correlation of swede score by the two methods and diagnostic efficacies were calculated with histopathology as gold standard.
Results
100 women had swede score of 5 or above with Gynocular and 86 of these had high swede score on colposcopy also. Histopathology was available for these 86 women. Both colposcopy methods were in strong agreement (Kappa = 0.795; p < 0.001) for swede scoring. HPE showed CIN 1 in 13.95%, CIN 2 in 4.65%, CIN3 in 6.98% and invasive cancer in 13.95% women. The HPE based sensitivity, specificity, negative and positive predictive values for Gynocular(100%, 61%, 100% and 22% respectively) were comparable with Standard colposcope.
Conclusions
Gynocular has comparable diagnostic accuracy with standard colposcope in diagnosing CIN.
Similar content being viewed by others
References
Organization WHO (2013) WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention: supplemental material: GRADE evidence-to-recommendation tables and evidence profiles for each recommendation.
Kass A, Slyper R, Levitz D. Optical design of low cost imaging systems for mobile medical applications; 2015. International Society for Optics and Photonics. pp. 93140B-93140B-93146.
Mink JW, Wexler S, Boldon FJ, Hummel C, Kahn BS, et al. Initial clinical testing of a multi-spectral imaging system built on a smartphone platform; 2016. International Society for Optics and Photonics. pp. 96990R-96990R-96995.
Bolton FJ, Weiser R, Kass AJ, Rose D, Safir A, et al. Development and bench testing of a multi-spectral imaging technology built on a smartphone platform; 2016. International Society for Optics and Photonics. pp. 969907–969907–969906.
Rashmi B, Vanita S, Radhika S, et al. Feasibility of using mobile smartphone camera as an imaging device for screening of cervical cancer in a low-resource setting. J Postgrad Med Educ Res. 2016;50:69–74.
Catarino R, Vassilakos P, Scaringella S, et al. Smartphone use for cervical cancer screening in low-resource countries: a pilot study conducted in Madagascar. PLoS ONE. 2015;10:e0134309. https://doi.org/10.1371/journal.pone.0134309.
Nessa A, et al. Evaluation of the accuracy in detecting cervical lesions by nurses versus doctors using a stationary colposcope and Gynocular in a low-resource setting. BMJ Open. 2014;4(11):e005313.
Kushwah S, Kushwah B. Correlation of Two Colposcopic Indices for Predicting Premalignant Lesions of Cervix. J Midlife Health. 2017; 8(3): 118–123.
Ngonzi J, Bajunirwe F, Wistrand C, et al. Agreement of colposcope and Gynocular in assessment of cervical lesions by Swede score: a randomized, crossover pilot trial. J Low Genit Tract Dis. 2013;17:372–7.
Nessa A, Wistrand C, Begum SA, Thuresson M, et al. Evaluation of stationary colposcope and the gynocular, by the Swede score systematic colposcopic system in VIA positive women: a crossover randomized trial. Int J Gynecol Cancer. 2014;24:339.
Acknowledgements
The Gynocular was made available for this study through AOGIN (Asia Oceania research Organisation on Genital Infections and Neoplasia),India.
Author information
Authors and Affiliations
Contributions
The study was conducted by Prof NS and assisted by Dr NN. Dr SS and TS helped in the manuscript preparation, which was finalised by Prof NS.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Singh, N., Negi, N., Sharma, S. et al. Diagnostic Role of Portable Colposcope (Gynocular) for Diagnosis of Pre-Invasive Lesions of Cervix. Indian J Gynecol Oncolog 18, 69 (2020). https://doi.org/10.1007/s40944-020-00415-6
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40944-020-00415-6