A pilot study of upcycled smartphone-based colposcopy for visual inspection of cervix performed by community healthcare workers in rural Vietnam

Ga Won Yim, Jiyeon Lee, Kyungmo Yang, Chae Hyeong Lee, Nguyen Vu Quoc Huy, Minh Tuan Vo, Sangchul Yoon

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study assessed the feasibility of smartphone-based colposcopy (SBC) for visual inspection of the cervix by community healthcare workers in low-resource areas. Methods: This was a retrospective study conducted in community villages in rural Vietnam, where 177 participants were enrolled for a cervical cancer screening. Cervical images were obtained by pre-trained community healthcare workers using a portable, upcycled SBC (Samsung Galaxy Note 20). Images were taken before and after the visual inspection after acetic acid (VIA) examination. Captured images were stored on a web server through an Android-based application and later reviewed independently by two experienced gynecologists. Image quality was assessed, and kappa statistics were calculated for the measurement of agreement in VIA findings. Results: Cervical images of 177 women obtained between July and August 2020 were analyzed. The mean age of women was 42 ± 9.1 years, and 20.3% were postmenopausal. The percentage of adequate visibility of the squamocolumnar junction (SCJ) in the captured images was 83.1%. The kappa value for interobserver reliability was 0.61 for VIA positivity agreement between the two gynecologists. Image clarity was rated as average or above in 77.3%. The reasons for suboptimal clarity were poor focusing (15.3%), inadequate SCJ visibility (18%), and obscuring of the transformation zone due to blood (11.3%), discharge (14.7%), or artifacts such as intrauterine devices or polyps (5.1%). Conclusion: Upcycled SBC was feasible when performed by pre-trained healthcare workers in a low-resource setting. VIA findings by SBC showed adequate agreement between two independent assessments, suggesting its potential as a method to aid cervical cancer screening.

Original languageEnglish
Pages (from-to)518-524
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Volume168
Issue number2
DOIs
StatePublished - Feb 2025

Keywords

  • colposcopy
  • community health worker
  • mobile applications
  • screening
  • smartphone
  • uterine cervical neoplasms

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