AI Can Cerv: CerviQMed Corp.’s Comprehensive Program To Eliminate Cervical Cancer In The Philippines using Artificial Intelligence (AI) Technology

by Ronnie Serquiña

INTRODUCTION

Cervical cancer is the 2nd most common cancer among Filipino women (Filipina).  There are an estimated 7,897 new cases every year and about 4,052 die from the disease.(1)  This translates to almost 11 Filipina succumbs to cervical cancer every day.  

Cervical cancer is caused by human papillomavirus (HPV). Out of the 100 types of HPV, there are 14 high risk types that are cancer-causing viruses. Two of which cause 70% of cervical cancers and pre-cancerous cervical lesions.(2) In spite of being preventable and curable, 52% of those who contracted the disease die annually. 

The biggest impacts of cervical cancer are on poverty, education, and gender equity. About 85% of deaths occur in the developing world, and many of those who die are relatively young women and are among the breadwinners of the family.(3)

In the Philippines, it is not unusual to endure sickness or to simply resort to self-medication. Doctor’s consultation is at a dismal 20%.(4) In most cervical cancer patients, signs and symptoms don’t show until cancer has advanced. Depending on the cancer’s stage and progress, treatment plan may include surgery, chemotherapy, and radiation therapy. The high mortality rate is attributed to the fact that 75% of women are diagnosed at late stage, and the treatment being frequently unavailable, inaccessible or non-affordable.(5)

Vaccine HPV Video

CHALLENGES

In the 2001/2002 WHO Health Survey, there’s a dismal 7.7% total cervical cancer screening Filipino women aged 18-69 years through Pap smear. In a study by the University of the Philippines-Department of Health (UP-DOH) Cervical Cancer Screening Study Group (2001), they attributed the causes of failure of cervical screening to:(6)

    1. lack of knowledge about symptoms associated with cervical cancer,
    2. a fatalistic attitude towards cancer and lack of awareness that cervical cancer is curable,
    3. lack of cytologic screening facilities and expertise and of treatment facilities in rural areas,
    4. lack of patient compliance with follow-up and treatment.

In addition, the risk is higher for women of low socio-economic level because they are less likely to attend cervical screening than women who are better-off, so they are more likely to develop the disease. In a poverty stricken area, most working women are breadwinners of their families and could hardly make both ends meet. Seeing a physician is a luxury they can’t afford. The cheapest cervical screening costs more than twice the amount of the daily minimum wage.

The fact that no signs and symptoms show up until the later stage of the cancer, most women do not set aside a budget to visit a physician for checkup, moreso for cervical screening.  The Philippines does not have any organized cancer-screening program.(7) There’s also a lack of data collection and repository which is essential for research and development. Our cancer registry only has 25% coverage of the entire population. Public knowledge and awareness on the benefits of cancer screening tests are also to be desired. Even health professionals lack education and training. Apart from the few numbers of screening and treatment facilities, they are disproportionately distributed. They are concentrated on urban areas and very few, almost none, on rural areas. 

The high cost of cervical cancer treatment makes it almost impossible for women, especially those who are financially challenged, to opt for treatment. Financial assistance can be solicited from several government agencies, not-for-profit and socio-civic organizations, philanthropic individuals, friends, and relatives. However, most support doesn’t cover the entirety of treatment which ranges from 9,000 pesos for the simple procedure (cryotherapy) to more than 200,000 pesos for radiation plus chemotherapy which would go on for 1 and a half months.(8)

SOLUTIONS

In November 17, 2020, the World Health Organization (WHO) launched its Global Strategy to Accelerate the Elimination of Cervical Cancer(9) wherein they outlined three key steps to end cervical cancer worldwide, i.e.,  vaccination, screening and treatment. The goal is to reduce more than 40% of new cases of the disease and 5 million related deaths by 2050.

WHO Call To End Cervical Cancer
CerviQ Team Members Backdraft

WHO established a roadmap that will place all countries on the path toward elimination when met by 2030:

    • 90% of girls fully vaccinated with the HPV vaccine by 15 years of age
    • 70% of women screened using a high-performance test by age 35 and again by 45
    • 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated and 90% of women with invasive cancer managed).

This strategy stresses that meeting these targets will generate substantial economic and societal returns. The increase of women in the workforce has put an estimated US$3.20 return to the economy for every dollar invested through 2050 and beyond. It will rise to US$ 26.00 when the benefits of women’s improved health on families, communities and societies are considered.

In the Philippines, since 2019, CerviQMed Corp. (CerviQ) has been actively campaigning and doing medical missions to address the alarming number of cervical cancer incidence among Filipino women. The WHO’s Global Strategy has affirmed CerviQ’s advocacy to end cervical cancer in the Philippines.

CerviQ is a social enterprise that helps eliminate cervical cancer in the Philippines through cervical cancer awareness, prevention, early detection, and  treatment; and to strengthen our data repository for comparative studies, research purposes and to improve our cancer registry. We serve as an efficient channel liaising medical experts and vulnerable individuals through a digital platform to reinforce awareness, engagement, training, and education for all stakeholders including medical professionals, local and national leaders, government offices and departments, private firms, socio-civic organizations, communities, families, and individuals.

CerviQ aims to be the premier non-government entity specialized in the promotion of cervical care and cervical cancer eradication in the Philippines. Our goal is to help eliminate cervical cancer in the Philippines through affordable, accessible, and efficient implementation of methodologies using Artificial Intelligence (AI) based technology and multi-platform campaigns.

To address the lack of knowledge about symptoms associated with cervical cancer and the fatalistic attitude toward the disease, CerviQ is combining both the traditional and the digital form of marketing to reach out to our audience. Online webinars and on-site seminars are being conducted to increase the awareness on the prevention, signs and symptoms, and treatment of cervical cancer. We have created CerviQTV Plus page on Facebook and CerviQ on YouTube to host our weekly program AI Can Cerv (I Can Serve) wherein we evangelize the need for cervical screening especially among reproductive-age women, and those who have experienced sex even at an early age.

CerviQ TV poster

To tackle the lack of cytologic screening facilities and expertise and of treatment facilities in rural areas, CerviQ is partnering with medical clinics in rural areas wherein we employ dedicated personnel to conduct cervical screening in their respective clinics. Our personnel need to undergo and pass our rigorous training to ensure that they will perform in accordance to CerviQ’s quality standards.

We fully understand the lack of patient compliance with follow-up and treatment. The usual cervical screening will take about 3 to more than a week to get the results. The waiting causes anxiety to the patient. The incidence of non-compliance is higher in far-flung areas where screening facilities are afar. To resolve this, CerviQ has partnered with a Korean technology company that manufactures Artificial Intelligent (AI) colposcope devices with 93% Sensitivity and 89% Specificity. This portable AI colposcope device combined with visual inspection using acetic acid (VIA) generates highly accurate results within 5 minutes. Screening can be done at a clinic or the device can be transported to remote areas where screening facilities are not available. The device beams the reading over the internet to a secure server and the AI algorithms will review and send the result back to the device for printing. Internet connectivity will be an issue, especially during remote missions. To address this, CerviQ has partnered with a telecom company to ensure strong connectivity during the screening. We’re also teaming up with a pharmaceutical company that distributes HPV vaccines so we can administer the vaccination to those who want to avail it.

The greatest deterrent for a patient to undergo cervical screening is the cost. The additional health protocols brought about by the pandemic has even made the screening less affordable especially for the financially challenged. With this, CerviQ, being a social enterprise company, has been actively engaging in businesses that will generate funds to cover the cost of cervical screening. Our target is to offer it for free to women in the remotest area of the Philippines where medical assistance is lacking. We are also tapping other sources and sponsors like socio-civic and non-profit organizations, government offices and private firms, philanthropic individuals, and international partners.

PROSPECTS

In June 2021, CerviQ inked a partnership with AIDOT of South Korea through Korea’s ICT Business Partnership 2021 program to provide cutting-edge technology in cervical screening in the Philippines. AIDOT’s Artificial Intelligence (AI) assisted colposcopy, Cerviray, will be utilized for cervical screening in CerviQ clinics and partner health institutions, especially in areas where cervical screening is scarce to non-existent.

ICT Business Partnership 2021
Screenshot 80

Cerviray is an ingenious and innovative technology compared to the usual colposcopes available in health facilities. It is small in size, which makes it more portable and cost cheaper. Traditional colposcopes are bulky and can cost tens of thousands of dollars. More importantly, Cerviray incorporates AI technology, which other portable colposcopes do not. It provides an accuracy rating of 93% sensitivity and 89% specificity. With this innovation, results can be out within 5 minutes compared to the usual waiting time of 3 days to 1 week.

The goal is to have 1 Cerviray in 146 cities and 1,488 municipalities in the Philippines and can be expanded to the 42,046 barangay. These numbers do not include government-owned and private health institutions.

According to PSA, of the 37.9 million women in the Philippines in 2005 ( in 2020), 51% belonged to the reproductive age group, 15 to 49 years. In 2020, PSA reported an increase of women population to 54.6 million or 49.5% of the populace. Thus, by 2030, our women population is projected at 63.65 million.

Macrotrends plotted an average population growth rate of 1.72% from the year 2000 to 2021. Given that the reproductive age group is at 51%, we’re looking at 27.8 million in 2021 to 32.46 million by 2030. Thus, following the WHO target of 70% cervical screening, and a frequency of 1 screening per year, 19.49 million Filipino women should be screened in 2021 and 22.72 million by 2030. To accommodate this number and hit the target, we need to have 2,670 facilities conducting cervical screening on 20 patients every day and 3,113 facilities by 2030.

To realize this goal, we need to train at least 1 to 2 personnel for each facility on the use of Cerviray. This program will open up possible employment for women throughout the country, given that this program is on women’s reproductive health. Though the purpose is medical, Cerviray can be operated by non-medical and non-professional staff. 

 

CONCLUSION

Cervical cancer is not merely a medical issue —factors involving socio-politics, religion, economics, and culture are parts of vulnerabilities that directly contribute to cervical cancer elimination programs’ success (or failure).

Cancer, per se, is a social disease. The burden is not only felt by the individual but also impacts the people within her microcosm. A woman who lost her battle to cervical cancer lost opportunities and economic resources for herself, her family, and society.   

The elimination of cervical cancer is a comprehensive project involving an enormous interdisciplinary approach to achieve success. Stakeholders include advocates like CerviQ, government institutions in the health and technology sectors, medical and allied professionals, private and not-for-profit organizations, national and local government, local and international civic organizations, survivors and their families, philanthropic and ordinary citizens, and vulnerable individuals. These multi-disciplinary groups must invest their commitment to addressing the issue by focusing on their respective discipline and collaborating closely with other stakeholders. CerviQ serves as the central body to liaise with other interconnecting bodies to ensure proper implementation of procedures and efficient delivery of services to the intended audience.

No woman deserves to have cervical cancer, let alone die of it. We must empower women to govern their health through proper education, engagement, and participation. Our mission is to protect them, nurture them, and encourage them to grow and be, more than ever, a more vital force in building a more robust economy for its citizens. Together, we can.