Low-cost technology for screening uterine cervical cancer

We report on an illuminated, low-cost (Rs 1500 (US$ 36)) magnifying device (Magnivisualizer) for detecting precancerous lesions of the uterine cervix. A total of 403 women attending a maternal and child health care clinic who had abnormal vaginal discharge and related symptoms were referred for deta iled pelvic examination and visual inspection by means of the device after the application of 5 % (v/v) acetic acid. Pap smears were obtained at the s ame time. The results were compared with those obtained using colposcopy an d/or histology. The Magnivisualizer improved the detection rate of early ca ncerous lesions from 60%, for unaided visual inspection, to 95%. It also pe rmitted detection of 58% of cases of low-grade dysplasia and 83% of cases o f high-grade dysplasia; none of these cases were detectable by unaided visu al inspection. For low-grade dysplasia the sensitivity of detection by mean s of the Magnivisualizer was 57.5%, in contrast with 75.3% for cytological examination. However, the two methodologies had similar sensitivities for h igher grades of lesions. the specificity of screening with the Magnivisuali zer was 94.3%, while that of cytology was 99%. The cost per screening was a pproximately US$ 0.55 for the Magnivisualizer and US$ 1.10 for cytology.