Issues

Cervical cancer is a leading cause of death in underserved areas of Brazil, which are often located thousands of kilometers from the nearest facility where diagnostic follow-up and treatment are administered. In the northern part of São Paulo state, Barretos Cancer Hospital has been a pioneer in new mobile strategies for cervical cancer prevention–instead of requiring each patient to travel long distances to a central facility, a mobile vehicular clinic makes routine visits to see patients in their city. While this approach overcomes geographical limitations, new technological innovations are required to administer cervical cancer care in remote locations without compromise in the quality of care. Hunt et al (page 359) report on a cluster randomized trial involving a mobile diagnostic van equipped with a tablet-interfaced in vivo microscope. This microscope is a low-cost fiber-optic imaging device that can assess subcellular morphologic features in real time and plays an important role in this mobile strategy. The micrograph featured on the cover of this issue was acquired from a suspected cancer precursor lesion using the in vivo microscope and correctly identified by the automated analysis algorithm as requiring treatment.