NEW DELHI, 1 OCTOBER: A team of researchers from IIT Roorkee are working to develop a fast and sensitive point of care diagnostic kit to detect Cervical Cancer…
Cervical cancer is one of the most preventable and treatable forms of cancer. Yet, it continues to be the fourth-most common type of cancer and cause of death from cancer worldwide. According to a report by World Health Organisation, an estimated 604,000 women were diagnosed with cervical cancer across the world and about 342,000 women died from the disease in 2020.
More than 95% of cases of cervical cancer happen due to persistent infection with high-risk types of human papillomavirus (HPV), an extremely common family of viruses that are majorly transmitted through sexual contact. Vaccines exist that protect against high-risk HPV types. Infact, India recently got its first indigenously developed vaccine, “CERVAVAC” for the prevention of cervical cancer.
However, the fundamental measure to prevent cervical cancer remains to be its early & timely detection. Today, diagnostic tests are an important aspect of medicine along with therapeutics and vaccination. It is the “third imperative” for reducing the burden of any disease.
A team of researchers from IIT Roorkee are working to develop a fast and sensitive point of care diagnostic kit to detect the most oncogenic strain of HPV i.e., HPV16. Under the supervision of Professor Harsh Chauhan and his PhD students, IIT Roorkee’s team iGem is developing ‘Crisprly’ – a cost-effective and easy-to-use kit for use in low-resource settings without the need for special equipment or a trained professional.
We need this innovation, and we need it now. Why?
About 70% of cervical cancers and 90% of deaths occur in developing countries, with one-third of the world’s cases being from India. According to a report published by the HPV Information Center (WHO IARC initiative), 483.5 million women in India are at risk for cervical cancer.
The situation seems grim because of the lack of awareness multiplied by the inaccessibility of screening facilities. Often, people tend to ignore symptoms due to various factors such as economic conditions, taboos, reluctance to visit a doctor, etc. As per a report by IRAC, high incidence rates and high mortality rates of cervical cancer occur mainly (~90% for both) in low- and middle-income countries.
Sexual health and education continue to be taboo in many societies like India. There’s hardly any mainstream discourse, especially among women in rural parts which significantly impacts the odds of them actively seeking out tests and treatment, despite its prevalence. This, coupled with psychological factors like the fears of a painful and invasive test, anxieties about the results and embarrassment grows reluctance among people to come forward for screening.
Several diseases end up not being diagnosed at an early stage as they show no symptoms during the initial stages. The most common example being that of cervical cancer, which is one the most treatable types of cancer but due to its untimely diagnosis, it has become a concerning issue.
Many studies reveal that effective prevention of cervical cancer right now is clearly most lacking in the secondary stage of prevention, i.e., an accessible, and effective screening and testing programme facilitating early detection and treatment. This is where IIT Rorkee’s Crisprly could help India take a leap in making cervical cancers preventable right at the initial stage.
How will Crisply be different from existing screening methods?
Currently, prevalent methods of screening and detection come with multiple issues. For example, the most common test for cervical cancer, Pap Test, causes pain and can aggravate existing intra-epithelial lesions in the birth canal. Such invasive methods lead to the lack of compliance of patients and increase inhibitions when it comes to getting tested.
Testing also relies on sophisticated equipment that mostly requires trained personnel to operate, subsequently affecting accessibility and cost. Moreover, most HPV screening involves time-taking methods, for example, PAP test results come in 1-3 weeks.
On the other hand, Viral DNA detection requires strain-specific probes or primers since techniques rely on identifying the viral capsid gene, which significantly varies and isn’t specific or conserved. All these methods have evident portability issues and are also expensive compared to testing with home-based sample collection kits that tend to be much more cost-effective.
Crisply – a fast & sensitive point of care diagnostic kit
“We aim to design a fast and sensitive point of care diagnostic kit to detect the most oncogenic strain of HPV i.e., HPV16,” a team member told PBNS, elaborating that this kit would be cost-effective and easy to use. It is designed for use in low-resource settings without the need for special equipment or a trained professional.
Unlike existing diagnostic methods that use the L1 protein in the viral capsid, Crisply’s method is based on the highly conserved E7 oncogenic gene found in hpv16 making the kit very sensitive, effective, and specific to HPV that could become cancerous.
Quite an easy Process!
The patient would be required to take a vaginal swab from which the virions would be extracted using a synbody system. DNA would be extracted from the capsid, amplified, and then subjected to the CRISPR/Cas12 system. Detection would be done using a fluorescent receptor (DNA probe) which would be detected through a lateral flow assay.
“Our project’s spawn point was an earnest belief in the urgency and relevance of the issue of the disparate, disproportionate effects of cervical cancer,” the team says.
In a broader picture, Crisply would provide a unique opportunity for developing countries to integrate screening of cervical cancer in primary health-care settings as well as at-home diagnosis. “Currently we are running digital simulations for the procedure while also performing reactions in which we have achieved proof of concept,” the team informs giving hope that Crisply, when it is launched, would help India reduce the burden of Cervical Cancers by easily screening them at initial stages.