Team:ZJU-China/Description
Inspiration
One day on April, before the group meeting, our girls were chatting:
"Hey! Have you guys taken the HPV vaccine? I went to the hospital today but they told me to wait until the reservation is open, what's that?"
"Well, don't know that you have to 'queue up' for the HPV vaccine? But I recommend that you should not wait for the 'open day', the vaccine is so limited that my mom couldn't get one in the last two years. Go to Singapore or somewhere else for the vaccine might be better."
There is a serious shortage of HPV vaccines supply in China, therefore, many girls cannot get the necessary protection. It is a huge problem, but what can we do to help them now?
"Other than vaccination, early screening for High-risk HPV infection may also make a difference!"
"But HPV screening is so embarrassing, they have to get the sample from your cervix, I don't like it."
"Wait, wait, wait. Do you mean cervical epithelial cells? Can we get them from menstrual blood or urine?"
Luckily, further literature research shows that menstrual blood is an excellent potential sample for HPV detection.
That's how we got start, for protection, for saving, maybe also for clarifying, that menstruation, is not an enemy, but a good friend who can fight for women's health and fight against Cervical Cancer.
Background
Cervical Cancer is the most or second most common cancer among women in developing countries. In 2018, approximately 311,000 women died from CC; more than 85% of these deaths occurring in low- and middle-income countries (WHO, 2019). In China, the incidence of Cervical Cancer continued to rise from 1998 to 2014 (Figure 1A, 1B). About 48,000 Chinese women die from it annually (HPV Information Centre). Patients may suffer from foul-smell discharge, vaginal discomfort, swelling of legs and vaginal bleeding. Even those who get cured by surgery will lose fertility in most cases, which will surely bring great pain not only to patients, but a family. The only "criminal" to blame is undoubtfully HPV.[1] Thus, screening for HPV will surely be an effective way of protecting women from Cervical Cancer.
Figure 1. Incidence of Cervical Cancer in China over time.
(A) Incidence of Cervical Cancer in China from 1998 to 2012, data from WHO CI5. Only five regions in China were involved, they are Shanghai, Jiashan, Zhongshan, Harbin and Hong Kong. population.
(B) Incidence of Cervical Cancer in China from 2009 to 2012, data from National Central Cancer Registry (NCCR). The whole country is involved.
*ASRIW: Age-standardized rate of incidence by the world standard.
*ASRIC: Age-standardized rate of incidence by the Chinese standard population in 2000.
Existing methods
Presently, the most common way used for Cervical Cancer wide-range screening is TCT and HPV infection detection based on PCR and DNA probe. These methods’ effectiveness was solidly proved in many high-income countries. However, these countries are minority over the world, for many resource-poor settings, the HPV screening is hard to popularize as there are some shortages with present methods:
(1) Invasive sampling. Doctors have to get some Cervical epithelia cells with a brush (Figure 2), which will not only cause physical pain sometimes, but bring psychological challenges to many patients.
Figure 2. Invasive sampling for Cervical Cancer detection.
Pictures from U.S. NATIONAL CANCER INSTITUTION.
(2) Requiring for special equipment and professionally trained testing personnel, which limit its application scope. For women in remote areas, they often cannot find a place for the screening.
(3) The price is pretty high. According to our investigation, the price of HPV detection ranged from 200 to 580 yuan (30-82 dollars).
(4) Time-consuming, many urban women get involved with their work and have no time to go to the hospital for a detection deliberately.
(5) Many vaginal infections may cause vaginal swelling and inflammation. For these patients, invasive sampling is not considered medically acceptable because they may aggravate the condition.
Because of those shortages, the Cervical Cancer regular screening ratio remains low in China, according to our investigation and a survey done by Women’s Hospital School of Medicine Zhejiang University, maybe lower than 30%. Apparently, it will never be able to protect people from cancer if women are not willing to do such an examination.
Our solution
It’s not hard to conclude that the vital shortages of traditional screening are firstly, Invasive sampling; and secondly, Inconvenience. Thus, the initial aim for our HPV screening tool, PaDetector, is to overcome these two problems. Here are our solutions:
Visit the page of Design and Hardware to learn more.
Application
Our project is aiming at providing a more friendly and convenient way for cervical cancer early screening for the concern of women health. Thus, how to apply the project into practice is of vital importance. We communicated with our potential users frequently in order to get feedbacks about our design from them. We collected advices from hospitals to pad industries to ensure PaDetector’s practicability. We conducted detailed business plan for our future development by analyzing market data and summarizing related policies. Entrepreneurship has always been embedded in our projects.
Considering that both Cas12a biosensing system and HCR biosensing system are extremely portable, they can be applied into a broader range to screen different kinds of diseases. However, in order to expend the application scope of PaDetector, we may need to deal with thousands of billions of biomarkers or establish databases for all sorts of diseases. Thus, we developed a Database Management System (DBMS) for biomarkers. It is designed for handling millions of data and equipped with a powerful search function, which meets our urgent needs perfectly.
Reference
[1] Chetty, R. 70 years of the JCP-highly cited papers: The causal relation between human papillomavirus and cervical cancer. Journal of Clinical Pathology 70, 997, doi:10.1136/jclinpath-2017-204867 (2017).
