Development of a cost-effective optical system for detection of cervical pre-cancer

Abstract

Cervical cancer is an important problem. The incidence of cervical pre-cancer is increasing, and unless current diagnostic techniques are improved, mortality and cost may increase substantially. The goal of our project is to find the most cost-effective optical system for the detection of cervical pre-cancer. Our hypothesis is that using fluorescence spectroscopy, a new technique for detection of cervical cancer and pre-cancer, will maintain the current technique's sensitivity, increase its specificity, and reduce its cost. In this paper we present a new method to calculate the fluorescence efficiency (FE) of human cervical tissue, based on in vivo measurements of 381 sites from 95 patients. This value is used in signal to noise ratio (SNR) calculations to evaluate the performance of different optical systems for detection of cervical pre-cancer. We verify that the predicted SNR values, obtained using FE, agree with the SNR of the patient's spectral data. We use the resulting data to generate a receiver-operator characteristic (ROC) curve that compares spectroscopy to the current standard of care. Finally, preliminary results of our economic analysis estimate that use of fluorescence spectroscopy could save $2.1 billion annually in the US.