Emerging Optical Techniques for Detection of Oral, Cervical and Anal Cancer in Low-Resource Settings

Review Article

Austin J Biomed Eng. 2014;1(2): 1007.

Emerging Optical Techniques for Detection of Oral, Cervical and Anal Cancer in Low-Resource Settings

Bing Yu1*, Daron G. Ferris2 and Yang Liu3 and Vivek Krishna Nagarajan3

1Department of Biomedical Engineering, University of Akron, USA

2Department of Obstetrics and Gynecology, Georgia Regents University, USA

3Department of Biomedical Engineering, University of Akron, USA

*Corresponding author: :Bing Yu, Department of Biomedical Engineering, University of Akron, Akron, OH 44325-0302, USA.

Received: March 20, 2014; Accepted: April 10, 2014; Published: April 14, 2014

Abstract

Cancers of the oral and anogenital regions are a growing global health problem that disproportionately impact women and men living in developing countries. The high death rate in developing countries is largely due to the fact that these countries do not have the appropriate medical infrastructure and resources to support the organized screening and diagnostic programs that are available in the developed world. Emerging optical diagnostics techniques, such as optical spectroscopy, reflectance imaging, and fluorescence imaging, are noninvasive techniques that are sensitive to multiple cancer biomarkers and have shown the potential as a cost–effective and fast tool for diagnosis of early precancerous changes in the cervix, oral cavity and anus. This paper provides a review of current strategies for prevention, screening and diagnostic tests of oral, cervical and anal cancers and development in optical diagnostic techniques that could potentially be used to improve current practice in resource–limited settings.

Keywords: Oral Cancer; Cervical Cancer; Anal Cancer; Low–Resource Settings; Optical Imaging; Optical spectroscopy

The global burden of HPV–related cervical, anal and oral cancers

Each year there are more than 750,000 cases of anogenital and oropharyngeal cancers [1]. Of these human papillomavirus (HPV)–induced cancers, there are 528,000 cases of cervical cancer with 274,000 deaths per year (Figure 1a) [1]. The majority of these cases (approximately 85%) occur in resource–poor countries [1,2]. Worldwide, cervical cancer is the second most common cancer among women. The highest incidence rates of cervical cancer are found in Central and South America, Africa and Asia where rates exceed 50 cases per 100,000 women. Because of the lack of modern prevention practices in these areas, the global mortality rate of cervical cancer is estimated to increase by 25% during the next 10years [2]. While the Pap test has substantially reduced the rate of cervical cancer, a preventable disease, too many women continue to suffer even in resource–rich countries. More women’s life years (death at a younger age) are lost with cervical cancer compared withovarian or breast cancer. Although less than 15,000 women in the United States develop cervical cancer per year, greater than ten–fold more are afflicted by precancerous conditions causing significant morbidity from additional diagnostic tests, histological sampling and surgical interventions. This toll occurs despite compliant surveillancepractices in resource–rich nations. Yet, these secondary cancer prevention strategies are associated with tremendous expense ($8 billion⁄yr. in US), complicated logistics and significant morbidity.