AUTOCAST: The future of cervical cancer screening

Cancer accounts for nearly one-quarter of deaths in the developed world, exceeded only by heart diseases. Early diagnosis through cancer screening programs is one of the key methods facilitated in cancer prevention as it has the:

• Capability of reducing mortality; and
• Potential to reduce cancer severity due to treatment for earlier stage cancers often being less aggressive than that for advanced-stage disease.

Whilst cancer screening provides the possibility for earlier detection and treatment, such screening programs currently present issues concerning inaccurate results, extensive delays in acquiring results, and holdups in starting treatment. For this reason, it is important that new technologies and approaches are developed. The AUTOCAST project took cervical cancer (the second most common cancer in women worldwide) and its associated virus Human Papilloma Virus (HPV) as the model system to develop a novel, automated cancer screening technology which could improve the way that patients are screened.

AUTOCAST has provided a low-cost novel solution for cervical screening, by developing a unique, automated polymerase chain reaction (PCR) technology able to detect multiple HPV genotypes and cervical cancer biomarkers in parallel within a single smear test. Based on a microfluidic disposable cartridge which is capable of real-time PCR amplification and detection in microarray format, this can then be processed to allow for a rapid ‘point-of-care’ diagnostic.

The concept of a ‘point-of-care’ cervical cancer screening will help to improve cervical pre-cancer and cancer detection as it means that ultimately, a doctor will be able to take a smear sample from a woman and immediately test for the presence of HPV and biomarkers to determine whether that woman is at risk of developing cervical cancer. Such technology will provide information about the presence of the HPV, their genotypes and also about the prognostic, pathological markers such as the viral load and the expression of the biomarkers. In addition, it can reliably distinguish between high and low-grade cervical pre-cancer, a factor that is hugely important for the management of women with abnormal smears. This is an enormous improvement from previous practices where, after sampling, specimens were sent to a central laboratory for pap-smear testing (a manual, microscope-based evaluation).