Harnessing technology ‘Eva System’ to enhance diagnosis of cervical cancer.
By Christine Were, Program Manager, Reproductive Health
Cancer of the cervix is the fifth most common cancer among women worldwide. Cervical cancer is the second most common cancer after breast cancer at 19.3% and 20% of all reported cancers in Kenya, respectively (KEMRI, 2010). Cervical cancer is also the leading cause of death in women in Kenya.
Opportunities to prevent, cure and relieve suffering from cervical cancer exist through primary prevention of HPV infection, secondary prevention by screening, treatment of precancerous disease and early stages of cancer as well as tertiary care for women with invasive cancer. In Kenya, it is estimated that only 3.2% of women aged 18-69 years have been screened in any 3-year period (WHO/ICO Information Centre on HPV and Cervical Cancer, 2010). Various tests have been recommended as screening methods in Kenya. They include Visual Inspection with Acetic Acid (VIA), Visual Inspection with Lugol’s iodine (VILI), Cytology using Conventional Pap smear and HPV testing. While VIA/VILI is widely used in developing countries, it has lower specificity (49-86%) compared to cytology.
PS Kenya has contributed to this effort by equipping 75 Tunza Facilities to offer screening and Treatment of pre-cancer lesions by use of VIA/VILI to screen and cryotherapy machines to treat the positive lesions. Some of the challenges with VIA/VILI is inability to preserve images for possible consultation (quality assurance support) and for evidence based feedback to clients (visualization of the process). Many clients get influenced and make informed decisions when they visualize and internalize their health concerns. PS Kenya’s Strategy involves targeting women aged 30-49 with information on Cervical Cancer screening and treatment of pre cancer lesions through static and outreach models. Besides equipping the provider with skills and logistics, PS Kenya reinforced and established referral mechanisms for bigger lesions or suspicious cases that require further management.
In July 2016, PS Kenya approached Mobile ODT, a company that developed the Eva System (a system that uses technology to diagnose cervical cancer), for a possible partnership. Talks begun, a partnership proposal was written and in September of the same year, PS Kenya and Mobile ODT agreed to conduct a pilot that would run for a period of 3 months in 2 Tunza facilities i.e. Wama Nursing home in Rongai and Boores Clinic in Thika.
The Eva system is made up of 3 components i.e.
The Eva system is an image capturing device that used alongside VIA/VILI improves diagnosing of pre-cancerous lesions because visualization of the cervix is improved through magnification. The system provides the opportunity to capture images while performing cervical cancer screening using VIA/VILI and store in a cloud based data base for review at a later time. The captured images can therefore be shared for quality assurance support and mentorship so as to ensure clients are receiving the utmost level of care.
PS Kenya Staff Training provider at Wama Nursing Home and Boore’s Medical Clinic Respectively.
Provider taking images using EVA device during Cervical Cancer Screening at Boore’s Medical Clinic
Learnings after the 3-month pilot period showed that the EVA system aids in better visualization of precancerous cervical lesions, supports objective support supervision and improves the confidence of the client in the process and treatment uptake.