Cervical cancer remains one of the most preventable yet deadly diseases affecting Filipino women today. In line with the country’s push toward elimination, a significant milestone was recently achieved at the Gynecologic Section of Jose R. Reyes Memorial Medical Center (JRRMMC), where a live demonstration of speculoscope-assisted VIA (Visual Inspection with Acetic Acid) was conducted.
This event brought together leading gynecologic oncologists, fellows, and OB residents to witness firsthand how innovation can bridge the gap between accessibility and accuracy in cervical cancer screening.
A Gathering of Experts in Gynecologic Oncology
The demonstration was attended by respected leaders in the field, including:
- Dr. Lilli May T. Cole, Section Head of Gynecologic Oncology
- Dr. Genalin Fabul Amparo, Gynecologic Oncologist
- Dr. Irene Magiba-Tagayuna, Gynecologic Oncology
- Dr. Eleyneth I. Valencia, OB-Gyne Training Officer
- Dr. Eryka Peralta-Abella, Fellow-in-Training Gynecologic Oncology and other fellows
- OB-Gynecology residents of JRRMMC
Their presence underscores the growing interest among specialists in adopting innovative tools that can enhance early detection strategies.
Understanding Speculoscope-Assisted VIA
According to Dr. Bogs Rivera, founder of End Cervical Cancer Philippines Organization Inc., the speculoscope does not replace colposcopy, but instead enhances traditional VIA:
“It serves as a better alternative to naked-eye VIA by improving visualization, documentation, and patient engagement.”
During the demonstration, a patient with a suspicious cervical lesion was identified. While the speculoscope provided enhanced imaging, colposcopy remained essential for further evaluation, reinforcing that this technology complements—not replaces—existing gold-standard diagnostics.
Gynecologic oncologists present were notably impressed with the clarity and quality of cervical images, highlighting its potential role in improving screening confidence, especially in low-resource settings.
Building Toward AI-Powered Cervical Cancer Screening
A key highlight of the session was not only the vision of artificial intelligence, but also the practical application of digital image annotation in real-world cervical cancer care.
According to Dr. Bogs Rivera, the speculoscope enables more than just image capture—it allows precise annotation of cervical lesions, which is critical in expanding access to treatment, especially in geographically isolated areas.
How the Annotation-Guided System Works:
- Image Capture
High-quality cervical images are taken using the speculoscope during VIA screening. - Remote Expert Annotation
A specialist (Gynecologic Oncologist or trained physician) reviews the images remotely and annotates suspicious areas or lesions directly on the image. - Guided Treatment by Nurses
These annotated images are then used by trained nurses or midwives to perform targeted treatment such as thermal ablation, even in low-resource or remote settings. - Post-Treatment Imaging
After the procedure, a follow-up image of the cervix is captured and sent back to the physician. - Re-Annotation and Continuity of Care
The doctor can re-annotate residual areas if needed, guiding further treatment until adequate management is achieved.
Why This Matters
This annotation-driven workflow transforms cervical cancer care into a collaborative, telemedicine-enabled system, allowing:
- Task-shifting from specialists to trained nurses and midwives
- Standardized treatment guidance even without on-site experts
- Improved treatment accuracy through visual instructions
- Continuity of care with before-and-after documentation
This is particularly valuable in the Philippines, where access to gynecologic oncologists remains limited in many provinces.
Dr. Rivera emphasized that this system aligns with the broader collaboration with Department of Science and Technology – Advanced Science and Technology Institute, where annotated images—paired with biopsy-confirmed cases—will eventually help train an AI-powered Cervical Decision Support System.
“From simple image capture, we are now moving toward intelligent annotation, guided treatment, and eventually AI-assisted decision-making,” he shared.
Bridging the Gap: From Screening to Treatment
This innovation bridges a critical gap in cervical cancer programs:
- Many systems can screen
- Few can ensure timely treatment
With annotation-guided workflows, CerviQ and its partners are enabling a “see-and-treat-and-follow-up” ecosystem, even in decentralized settings.
Research Collaboration and Scaling Across LGUs
Another promising development is the partnership with University of California San Diego through the ParaSaKanyaPH research initiative. This international collaboration focuses on evaluating the economic and clinical value of speculoscope-assisted VIA compared to:
- HPV-DNA testing
- Naked-eye VIA
- Cytology (Pap smear)
Through this initiative, more than a dozen speculoscopes are expected to be deployed across LGUs and clinics in Luzon, with participating sites required to screen at least 100 patients per month.
Balancing Accuracy and Accessibility
A critical discussion point during the event centered on screening accuracy.
Dr. Cole acknowledged:
“In terms of accuracy, HPV-DNA testing remains the gold standard.”
However, she also emphasized the unique advantage of speculoscope-assisted VIA:
- Patients can see their cervix in real-time
- This visual engagement fosters awareness and empowerment
- It improves the likelihood of follow-up and repeat screening
This balance between accuracy and accessibility positions the speculoscope as a valuable tool in public health programs, especially in underserved communities.
Toward a Collaborative Future
The demonstration concluded with a strong commitment to collaboration.
Dr. Cole and the JRRMMC team expressed their willingness to work with CerviQ and DOST-ASTI in advancing this initiative. To operationalize this, the following were identified:
- A 3rd-year OB resident
- A 2nd-year OB resident
- A 1st-year OB resident
These trainees will work closely with CerviQ to:
- Understand the system workflow
- Learn device operation
- Explore integration into hospital-based screening programs
Looking Ahead: May 22 Mass Screening Initiative
The next major milestone is set for May 22, in celebration of National Cervical Cancer Awareness Month.
JRRMMC will host a large-scale VIA screening activity, where the speculoscope-assisted VIA approach will be implemented in a real-world, high-volume setting.
This event will serve as a critical test of:
- Workflow efficiency
- Patient acceptance
- Clinical usability
- Data collection for AI development
Conclusion
The speculoscope-assisted VIA demonstration at Jose R. Reyes Memorial Medical Center marks a meaningful step forward in the Philippines’ journey toward cervical cancer elimination.
By combining clinical expertise, digital innovation, and collaborative research, initiatives like this are redefining how screening can be delivered—making it more accessible, engaging, and scalable.
While HPV-DNA testing remains the gold standard, technologies like the speculoscope provide a practical bridge—bringing life-saving screening closer to communities that need it most.
