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Author's profile photo Christine Donato

SAP and Heidelberg University Hospital Bring Cervical Cancer Prevention to the Women of Kenya


The Human Papilloma Virus (HPV) is the most common viral infection of the reproductive tract. According to the World Health Organization’s (WHO) Human Papilloma Virus (HPV) and cervical cancer fact sheet, 80% of women will become infected with at least one type of HPV during their lifetime. And of the 100+ types of the virus, 13 are cancer causing.

HPV infections do not usually cause any detectable symptoms and they can resolve spontaneously within a couple of months after the primary infections. However, in some the virus can persist and may eventually trigger preneoplastic lesions at the uterine cervix that, if untreated, can progress to invasive carcinomas. According to the WHO, HPV is reported to be related to nearly all cases of cervical cancer worldwide.

Cervical cancer is the fourth most frequent cancer in women, and 85% of all annual deaths from cervical cancer occur in women living in developing regions.

Screening tests for cervical cancer check for abnormalities related to persistent HPV infections and pre-cancerous lesions – and early detection and treatment by using respective tests can prevent up to 80% of cases.

Unfortunately, in less developed countries, screening is rarely, if ever, performed due to limited resources in the health care sector.

Kenya’s Cervical Cancer Concern

In Kenya, cervical cancer is the number one cause of cancer death, and the disease is 6 to 20 times higher for HIV-infected women.

According to The Averting HIV and AIDS Organization, Kenya has the fourth-largest HIV epidemic in the world. In women with healthy immune systems, cervical cancer takes 15 to 20 years to develop. But in women with weakened immune systems, such as those with untreated HIV infection, cervical cancer can develop in just 5 to 10 years.

Many of the infected women are young to middle aged, therefore, it’s critical to act fast in order to prevent a dramatic impact on families and even entire societies.

Making Cervical Cancer Screening Attainable in Kenya

To help mitigate the high number of deaths from cervical cancer, Heidelberg University Hospital initiated the Emerging Technologies in Cervical Cancer Screening (ETiCCS) project.

The project began with a year-long cervical cancer screening study with 800 women. Performed by the Moi Teaching and Referral Hospital, Kenya and funded by the German Federal Ministry of Education and Research, the study uses a specific method to detect an HPV infection via specific biomarkers. Women who are infected with HPV and at risk to develop cervical cancer can now be identified more easily and treated early to eliminate the development of cervical cancer.

Initially, this screening process was completely paper based. A woman would be recruited in a local health center and examined by a nurse. The nurse would then take a sample, send it to a laboratory, wait for the results, and contact the woman for a follow-up visit and perhaps treatment.

All documentation on this individual woman was manually transported between the recruiters, lab technicians, medical doctors, and researchers…a process which left much room for error on hundreds of cases.

Streamlining the Process to Help More Patients

ETiCCS7.PNGTo connect and improve all siloed portions of the screening process and to help the project run more smoothly, the Heidelberg University Hospital sought out industry partners to digitalize the paper-based process.

The SAP Design & Co-Innovation Center team joined the project as an experienced partner in delivering cloud-based software solutions, and Intel, an SAP technology partner, agreed to sponsor 10 Fujitsu Tablet PCs for the project.

The new solution, which runs on the SAP HANA Cloud Platform, mediates the high risk of data loss and duplication associated with paper-based screening processes in fragile infrastructures like Kenya.

The new app accelerates the recruitment, examination, and provision of cancer test results.  Local clinic workers in Kenya can directly input data and easily view patient information while remotely in Germany test results can be monitored by the Heidelberg University Hospital.

Internet connectivity is unstable in Kenya, therefore the local portion of the touchpad solution runs offline and can be synchronized to the cloud via an Internet USB stick twice a day.  The data will be available for stochastic analysis after initial studies are finished, creating a unified knowledge base for medical analysis and communication in practical medicine.

Future Goals

The next step for ETiCCS is to bring the solution closer to patients by eliminating the need for women to travel long hours to a health center. The project plans to offer a self-sampling test in larger, more rural areas with an ultimate goal to screen eligible women across the entire country. The project also envisions the adoption of smartphones to further simplify the process and provide full mobility.

“Through the ETiCCS program, we were able to complement applied medical research around biomarkers with the power of cutting-edge cloud technology to bring co-innovation to Africa in a way which really helps to improve people’s lives.”

Magnus von Knebel Doeberitz, MD, Medical Director, Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg

The ETiCCS project is more than just technology.  It’s helping to solve a socioeconomic problem and save women from a very common, but very preventable disease.

The ETiCCS project recently beat other prestigious organizations by winning the Design Value Award.  Read about it here.

For more on the ETiCCS project, watch this video and read the more detailed story here.

Follow me on Twitter @Cmdonato and on LinkedIn.

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