Goal: To stimulate development of low-cost, portable technologies to detect, evaluate, diagnose, and treat cancer in low resource settings.
NCI seeks to support the development of a generation of user friendly, low cost devices with high potential for the detection and diagnosis, or minimally invasive treatment of treatable cancers in low resource and rural settings. A useful device requires capability, effectiveness, sensitivity, and specificity comparable to currently used technologies. Many recently developed technologies appear to have this potential, and recent developments in consumer electronics, microfabrication, cellular phone communication and hand-held computers improve the prospects for their adaptation into sensitive, low cost versions that can deliver clinically useful technologies comparable to currently used technologies suitable for use in remote locations.
Examples of possible technologies include the following:
- In vitro diagnostics: Lab-on-a-Chip (LOC) and biosensor technologies allow the performance of chemical and biological assays outside of laboratory environments. These technologies exemplify one potential approach to Point of Care (POC) analytical tools for use in resource-poor settings using complex samples such as blood, saliva, urine.
- Imaging: Optical imaging, spectroscopy, and ultrasound hold great promise for use in resource-limited settings.
- Treatment: Cryotherapy has been reported as an effective, safe, and acceptable treatment for ablation of cervical intraepithelial neoplasia and is currently endorsed and recommended by the World Health Organization. Other portable, minimally invasive treatment methods also have been reported, such as laser therapy, radiofrequency ablation, low-power-density sonication, high-intensity focused ultrasound, and photodynamic therapy. There is limited data on the effectiveness of these approaches in low resource settings.
We are also interested in telemedicine approaches that leverage the widespread use of mobile phones (including smart phones) in LMICs. Examples of these include lens-free microscopy and cytometry using the CCD camera on a cellular phone, digital image processing to produce remote diagnoses such as a recent smart-phone application that automatically detects leukocoria for retinoblastoma diagnosis, and devices that expand the functionality of mobile phones and tablets, such as a recently marketed attachment for hand-held ultrasound.
Specifications for key technological solutions:
- Low cost
- Minimal consumables
- Battery powered
- Fast, clear, medically useful results
- Low training and maintenance needs
- Easy to use by local providers
- Minimally invasive cancer treatments
Existing technologies have been (or could be) adapted for use in Global Health. Our goal is to stimulate more efficient adaptations.