A device that uses light energy to rapidly diagnose precancerous and cancerous changes of the cervix is under study at the Medical College of Georgia.
"We are excited about the potential for a new way to diagnose women with these changes," said Dr. Daron G. Ferris, MCG family medicine physician, colposcopist and study investigator.
The Pap smear is the standard screening tool for finding these changes early on; treatment options include cryotherapy to freeze and destroy abnormal cells, surgery that uses a scalpel or electric cutting device to remove cells or laser treatment to vaporize them.
But clinical researchers at a handful of sites across the world are looking at the potential for fluorescence spectroscopy – which uses light energy, a computer and the natural fluorescence of some components of the skin of the cervix – for providing a more accurate, on-the-spot diagnosis of precancerous and cancerous changes and their precise location.
The Pap smear, recommended as a yearly screening for women who have had sexual intercourse, involves accessing the surface of the cervix, removing samples of exfoliated cells and sending them to a laboratory for analysis. The lab work can take days to weeks and doctors, such as Dr. Ferris, are concerned that many women don't follow up when test results are abnormal.
"We believe this device will allow the physician to evaluate the woman, to detect neoplasia that may be on the cervix and to notify her within a minute of scanning," Dr. Ferris said.
The device emits varying wavelengths of light which shine on the skin of the cervix. "Some of the light reflects immediately off the surface and some is absorbed by the skin and interacts with substances in the skin that are naturally fluorescent, which means they fluoresce or give off different wavelengths of light that are emitted back to the same probe," Dr. Ferris said.
"The light waves are carried to a computer with algorithms which categorize the response as normal, precancerous or cancer," he said, noting that the device not only identifies the location of changes, but categorizes them, which expedites the treatment process. "If we can diagnose the disease right there in the office and immediately begin to manage those patients, we've saved a step in the process," Dr. Ferris said.
For this study, Dr. Ferris is looking for women age 18 and older who already have had an abnormal Pap smear and need a colposcopy examination. These women are the study focus because their increased probability of having precancerous lesions or cancer will expedite the study's screening process. Fluorescence spectroscopy will add about five minutes to the standard colposcopy examination they would receive, he said.
In the general population, only about 3 to 5 percent of women have an abnormal Pap smear result. However, some women are found on follow-up to be free of precancerous or cancerous changes; their positive Pap tests result from another problem such as infection. If fluorescence spectroscopy is ever to replace the Pap smear as a screening device, it will have to be studied in the general population as well, Dr. Ferris noted.
For more information about the study, call Dr. Ferris' office at 706-721-2535.