Cervical cancer is easily detected through routine healthcare screenings, but many biological females without access to a family doctor are falling through the cracks and leaving cervical cancer undetected.
Local physician and researcher Dr. Karen Yeates is working toward the World Health Organization’s (WHO) goal to eliminate cervical cancer globally by 2030 with innovative screening strategies.
Dr. Yeates, a Professor of Medicine and a nephrologist at Queen’s University with a focus on screening/detecting and managing chronic diseases, first experienced the burden of cervical cancer and its high mortality rates in Tanzania when she was a visiting professor at the Kilimanjaro Christian Medical Centre in Northern Tanzania in 2010. There, women were presenting with late-stage, incurable cervical cancer due to a complete lack of screening in the low-resource health setting.
Current cervical cancer screening makes use of Pap tests, which haven’t changed much since they were introduced in the 1950s. Cervical cells are collected by a broom or cytobrush through the vagina, with the use of a speculum to hold the vaginal canal open to expose the cervix, which can cause discomfort for the individual being tested. The cell sample is dipped into a preservation medium in a collection bottle for processing for liquid-based cytology, or the sample on the spatula is smeared onto a glass slide and fixed with ethyl alcohol before a pathologist performs a cytopathological examination. Read more about Pap tests and screening on the Cancer Care Ontario website.
While in Tanzania, Dr. Yeates became passionate about the prevention of cervical cancer and developed a research program in collaboration with the Tanzanian Ministry of Health’s national cervical cancer prevention program. The program uses mobile technology (smartphones, tablets and other devices) to train nurses to do a visual inspection of the cervix after the application of acetic acid. A similar method is used in Canada for colposcopy, which is a way that gynecologists examine the cervix under a special lens (colposcope) after a woman has had an abnormal Pap smear.
Since 2012, when Dr. Yeates first received research funding from Grand Challenges Canada for the smartphone-based cervical cancer screening program, the team has screened over 30,000 women and provided preventive treatment for those found to be at risk of developing invasive cancer.
As part of that funding, Dr. Yeates founded WEMA Inc. here in Kingston — a not-for-profit organization with a team of local and international colleagues working in the women’s cancer prevention and research space globally. The organization delivers mobile phone-based diagnostic and treatment platforms that provide detection, management, and increased health knowledge and service uptake in a low-cost environment. This allows them to deliver services to those in need and who currently have limited access to essential health services.
Dr. Yeates currently directs a program of global health implementation science research in Tanzania with collaborative projects in Rwanda and Kenya that are focused on the prevention of women’s cancers. Her work to improve training, scaling, quality assurance and cervical cancer screening outcomes in Tanzania has been recognized by the WHO and the program has been integrated into the national Tanzanian Ministry of Health Cervical Cancer Prevention Program (CECAP).
A little closer to home, Dr. Yeates and her team in Tanzania are part of a nine-country consortium led by the National Institutes of Health and the National Cancer Institute in the United States that is working on developing a global AI solution for cervical cancer prevention in low- and middle-income countries called Automated Visual Evaluation (AVE) of the cervix. They are currently enrolling Tanzanian women into this global clinical trial that is targeting the enrolment of 100,000 women across the nine countries.
Separate from that endeavour, Dr. Yeates is also working with American innovators at PapEasy to link their project to the WEMA App platform that was developed at the Centre for Advanced Computing at Queen’s University. The WEMA App is used for tracking the screening results and supporting Tanzanian nurses and other health providers in navigating women through the cervical cancer screening and treatment pathway in Tanzania.
PapEasy was founded by Kamran Ayagh, a medical innovator, entrepreneur, and inventor, with more than 30 years of experience in leadership, R&D, marketing, and mechanical engineering. His project offers a preventative healthcare device that is simple, easy to use, and incorporates artificial intelligence to continually enhance and improve user experience for each woman in real-time. According to the PapEasy website, by privileging privacy, accessibility, speed, and regional and cultural specificity, PapEasy will enable women to self-screen through a ‘home-based screening kit’ – or be screened by a healthcare practitioner – more comfortably, quickly, and frequently.
The PapEasy Kit will provide a wand to collect the sample, which is then analyzed by software on a smartphone or other device. The wand will also preserve the sample for further analysis if necessary and the sample can also be used for Human Papilloma Virus testing to identify women who are at highest risk and require additional cytology testing for possible precancerous lesions or early cancer of the cervix. This innovation aims to remove barriers such as lack of healthcare options, discomfort with classic sampling methods, and economic status for those who reside where healthcare requires payment.
The PapEasy Kit and WEMA Inc. are in the final stages of integration, according to Dr. Yeates. The product will undertake clinical validation studies to further develop and evaluate the integration of the PapEasy device with the WEMA mobile app, an evidence-based cervical cancer screening program.
Dr. Yeates told Kingstonist she was introduced to Ayagh by Queen’s Partnerships and Innovation because they were both working to improve cervical cancer screening. Through the Kingston-Syracuse pathway, WEMA Inc. and PapEasy were brought together with Kingston as the starting Hub for their collaboration, according to Ayagh.
PapEasy’s Kingston office opened last month, and, according to Kingston Economic Development, who developed the Kingston-Syracuse pathway, the office serves as a catalyst in a global movement committed to eliminating cervical cancer mortality worldwide.
“Kingston’s robust network of supports makes it the perfect place for our global outreach. We are thrilled to join this inclusive community, dedicated to enhancing women’s health worldwide,” Ayagh stated.
“I met Dr. Karen through Upstate Medical University’s collaborative programs with Queen’s University, and PapEasy’s participation in their mentorship programs,” he told Kingstonist in an email.
“In the second half of 2022, PapEasy was picked among the four selected innovation startups to participate in accelerated and mentorship complimentary programs offered through CNY Biotech Accelerator, Upstate Medical University,” he continued. “Through the Kingston-Syracuse pathway, Kingston Economic Development Corporation provided informative and useful information about patents and regulations, fundraising and grants opportunities, proposal writings, working prototype and clinical trial requirements, provided many webinar opportunities to have firsthand access to professionals at no costs to PapEasy, commercialization readiness paths and generating road maps, and introducing many other wonderful contacts such as Dr. Karen.”
Dr. Yeates noted that the results of their combined studies will be to create a comprehensive and cost-efficient cervical cancer screening method that increases screening uptake and decreases loss to follow-up.
“The integration of our two innovations will benefit all women in the screening eligible age group, but, in particular, it will significantly benefit women who are afraid, who may have anxiety towards a speculum exam and have never been screened or are under screened, including those without access to a family physician,” she stated.
“The comfort, increased acceptability, and low-cost of the PapEasy kit, combined with the built-in quality assurance supported by the WEMA App program will ensure high quality screening takes place with or without a primary care physician and increase cervical cancer screening access to millions of unscreened or under screened women in Ontario.”