A study published in the Cancer Screening and Prevention journal has used low-cost video scopes to screen for HPV-associated oropharyngeal cancer.

The rise in the incidence of oropharyngeal squamous cell carcinomas (OPSCCs) linked to human papillomavirus (HPV)-16 infection has become notable, surpassing cervical high-risk HPV infections by 2019. HPV-associated OPSCCs present a better prognosis compared to traditional oropharyngeal malignancies, largely due to lower correlations with chronic tobacco and alcohol use.

Despite the sexually transmitted nature of HPV-associated OPSCCs, data on sexual behaviours is sparse in cancer registries, complicating correlation studies. Notably, high-risk factors in men include recent same-sex sexual activity, with significant odds ratios noted in studies.

The authors said this context underscores the need for accessible and effective screening tools to manage the increasing OPSCC burden, especially in resource-limited settings.

Materials and methods

In this study, the feasibility of using low-cost videoscopes to obtain high-quality ‘oral selfies’ for OPSCC screening was examined. The equipment included a $30 Depstech 86T industrial videoscope, known for its waterproof capability and high resolution, connected to a Windows PC laptop.

The participants were instructed to record a 20-30-second video of their oropharynx. The setup involved positioning the videoscope's head between the maxillary central incisors and capturing all anatomical landmarks. The videoscope’s ability to provide clear images of the oropharyngeal region was assessed through these recorded videos.

Results

Two sub-studies were conducted to evaluate the practicality and effectiveness of the videoscope. In the first sub-study, five volunteers recorded videos, with an average time of 36 seconds to capture all necessary landmarks.

Feedback from a focus group highlighted the ease of use, the novelty of viewing one's oropharynx, and the need for proper orientation of the videoscope. Marking the scope's top and initial practice was recommended for better results.

The primary barrier was controlling tongue position, which is critical for clear visibility of the palatine tonsils.

Nevertheless, the videos produced were of sufficient quality for diagnostic purposes. Participants reported that while the process was initially challenging, they quickly adapted and found it manageable.

The second study involved nine participants who successfully recorded their oropharynx videos, which were then graded on clarity and completeness. The average score was 3.1 on a 5-point scale, indicating that most videos provided a reasonably clear view of the oropharynx.

This sub-study reinforced the initial findings on the practicality and quality of using videoscopes. Reviewers noted that although some videos were imperfect, the overall quality was acceptable for screening purposes. The videos were evaluated based on several criteria, including lighting, focus, and the visibility of critical anatomical features.

Conclusions

The data suggests that commercially available videoscopes, coupled with laptops, can effectively produce clear and well-lit videos of the oropharynx.

The primary challenge remains the control of tongue positioning to avoid obstruction of key anatomical features. Despite this, the study demonstrates that with proper guidance and practice, individuals can use these low-cost devices to obtain videos suitable for screening OPSCCs.

The ease of use and affordability of the videoscopes make them a promising tool for widespread screening, particularly in low-resource settings where traditional medical imaging equipment may not be available.

The study also highlighted the potential for telemedicine applications, where these videos could be reviewed by specialists remotely.

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