The development of "automated visual evaluation" for cervical cancer screening: The promise and challenges in adapting deep-learning for clinical testing: Interdisciplinary principles of automated visual evaluation in cervical screening.

Journal: International journal of cancer
Published Date:

Abstract

There is limited access to effective cervical cancer screening programs in many resource-limited settings, resulting in continued high cervical cancer burden. Human papillomavirus (HPV) testing is increasingly recognized to be the preferable primary screening approach if affordable due to superior long-term reassurance when negative and adaptability to self-sampling. Visual inspection with acetic acid (VIA) is an inexpensive but subjective and inaccurate method widely used in resource-limited settings, either for primary screening or for triage of HPV-positive individuals. A deep learning (DL)-based automated visual evaluation (AVE) of cervical images has been developed to help improve the accuracy and reproducibility of VIA as assistive technology. However, like any new clinical technology, rigorous evaluation and proof of clinical effectiveness are required before AVE is implemented widely. In the current article, we outline essential clinical and technical considerations involved in building a validated DL-based AVE tool for broad use as a clinical test.

Authors

  • Kanan T Desai
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
  • Brian Befano
  • Zhiyun Xue
    Computational Health Research Branch, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
  • Helen Kelly
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
  • Nicole G Campos
    Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
  • Didem Egemen
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
  • Julia C Gage
  • Ana-Cecilia Rodriguez
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
  • Vikrant Sahasrabuddhe
    Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland, USA.
  • David Levitz
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
  • Paul Pearlman
    Center for Global Health, National Cancer Institute, Rockville, Maryland, USA.
  • Jose Jeronimo
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
  • Sameer Antani
    Computational Health Research Branch, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
  • Mark Schiffman
  • Silvia de Sanjosé
    Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.