Integrating pocket colposcope and telecolposcopy into VIA-based screening at primary healthcare centers for cervical cancer prevention in LMICs.

Cervical cancer is a prevalent global public health concern, particularly in low- and middle-income countries (LMICs). In such countries with limited resources, cervical cancer-mediated morbidity and mortality are also high due to a lack of effective screening and treatment facilities. Visual Inspection with Acetic Acid (VIA) is a non-invasive, low-cost alternative to cytology and HPV DNA testing. However, the efficacy of VIA is often compromised due to its low diagnostic accuracy and inter-subject variability. Integrating pocket and telecolposcopy with VIA at primary healthcare facilities may improve screening accuracy and coverage. This review examines published reports on the sensitivity and specificity of VIA, and highlights the limitations of cervical cancer screening programs in LMICs. It further discusses the challenges and opportunities of digital screening with pocket colposcopes and telecolposcopy, and the rationale for integrating these technologies with VIA in primary healthcare settings to improve cancer prevention coverage in LMICs.