India has made great progress in health care infrastructure in the recent years but in spite of that we see that we have about 1/3 of all deaths from cervical cancer globally. Unlike many other cancers of the female genital tract, cervical cancer occurs early and strikes at the reproductive age group. The incidence rises at 30 -34 years and peaks at 55-65 years. National institute of health tells us that we have a population of 453 million women above the age of 15 who are at risk of developing the disease. Hence every woman in India has a cumalitive risk of 2.5% of developing the disease or 1.4% cumalitive death risk from cervical cancer. Despite this, only 3.1% of women in India are screened. If we can pick up the problem at a precancerous stage, the prognosis is much better and the cost of treatment is brought down considerably.

 

In Kripa clinic we follow the following procedure:
All women over the age of 28 are advised to have the pap smear. At the same time cervical screening is done by enhanced visualization through a mobile colposcope. This service is offered at the clinic on an individual basis or in groups of 4 or 5 with prior appointment.

 

The EVA System is used for visualization of the cervix through three components:

● The Scope: a mobile, lightweight, and durable medical device for magnified inspection that includes an ultra-bright light source with glare-reducing cross-polarization technology, a lens enabling up to 16 times magnification for superior imaging, and a rechargeable battery for up to 10 hours of continuous examinations.
● The App: a mobile phone based application Cerv DX allowing capture of images and recording of clinical impressions and decisions. And then syncing all data to the online portal.

● The Portal: facilitates reviewing of these images and their clinical significance, helps in an online quality control, consultation, and analytic review from anywhere in the world.

The cervix is thus examined, as it is and then after treating with acetic acid to pick up the suspicious areas. Images are obtained on the phone, treatment option is indicated and the entire study is synced with the cloud via internet.
The results are obtained on the computer screen and a print out is given to the patient. This will help with follow up.
Pap smear is recommended for every woman after the age of 25. If the study is normal it can be repeated after 2 years but if any variations are seen it should be repeated according to the diagnosis.

Who are the ladies who should definitely undergo the test.
1. Those who are over 30 and have never had a cervical exam.
2. Those who have excessive vaginal discharge or abnormal discharge
3. Those with slight bleeding after intercourse.
4. Post menopausal ladies with spotting or bleeding PV.