Citation: Shrivastav, K.D.; Arambam,
P.; Batra, S.; Bhatia, V.; Singh, H.;
Jaggi, V.K.; Ranjan, P.; Abed, E.H.;
Janardhanan, R. Earth Mover’s
Distance-Based Tool for Rapid
Screening of Cervical Cancer Using
Cervigrams. Appl. Sci. 2022, 12, 4661.
https://doi.org/10.3390/
app12094661
Academic Editors: Keun Ho Ryu and
Nipon Theera-Umpon
Received: 23 March 2022
Accepted: 2 May 2022
Published: 6 May 2022
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Article
Earth Mover’s Distance-Based Tool for Rapid Screening of
Cervical Cancer Using Cervigrams
Kumar Dron Shrivastav
1
, Priyadarshini Arambam
2
, Shelly Batra
2
, Vandana Bhatia
3
, Harpreet Singh
4
,
Vinita Kumar Jaggi
5
, Priya Ranjan
6
, Eyad H. Abed
7,
* and Rajiv Janardhanan
8,
*
1
Laboratory of Health Data Analytics and Visualization Environment, Amity Institute of Public Health,
Amity University Uttar Pradesh, Noida 201313, India; kdshrivastav@amity.edu
2
Batra Hospital and Medical Research Centre, New Delhi 110062, India;
priyadarshini.arambam@gmail.com (P.A.); shells1857@gmail.com (S.B.)
3
Netaji Subhas University of Technology, Delhi 110078, India; vandana.bhatia@nsut.ac.in
4
Indian Council of Medical Research, New Delhi 110029, India; hsingh@bmi.icmr.org.in
5
Delhi State Cancer Institute (East), New Delhi 110095, India; drvinitakumar@yahoo.co.in
6
Bhubaneswar Institute of Technology, Bhubaneswar 752054, India; pranjan@gmail.com
7
Institute for Systems Research, University of Maryland, College Park, MD 20741, USA
8
Faculty of Medical & Health Sciences, SRM Institute of Science & Technology, Chennai 603203, India
* Correspondence: abed@umd.edu (E.H.A.); rajivj@srmist.edu.in (R.J.); Tel.: +91-96-5031-9728 (R.J.)
Abstract:
Cervical cancer is a major public health challenge that can be cured with early diagnosis
and timely treatment. This challenge formed the rationale behind our design and development of an
intelligent and robust image analysis and diagnostic tool/scale, namely “OM—The OncoMeter”, for
which we used R (version-3.6.3) and Linux (Ubuntu-20.04) to tag and triage patients in order of their
disease severity. The socio-demographic profiles and cervigrams of 398 patients evaluated at OPDs
of Batra Hospital & Medical Research Centre, New Delhi, India, and Delhi State Cancer Institute
(East), New Delhi, India, were acquired during the course of this study. Tested on 398 India-specific
women’s cervigrams, the scale yielded significant achievements, with 80.15% accuracy, a sensitivity
of 84.79%, and a specificity of 66.66%. The statistical analysis of sociodemographic profiles showed
significant associations of age, education, annual income, occupation, and menstrual health with the
health of the cervix, where a p-value less than (<) 0.05 was considered statistically significant. The
deployment of cervical cancer screening tools such as “OM—The OncoMeter” in live clinical settings
of resource-limited healthcare infrastructure will facilitate early diagnosis in a non-invasive manner,
leading to a timely clinical intervention for infected patients upon detection even during primary
healthcare (PHC).
Keywords: cervical cancer; cervigrams; colposcopy; early detection; screening
1. Introduction
Cervical cancer is a major unmet clinical need and is a serious public health problem.
Early detection is not widely available in developing countries, and the standard detection
method (Pap test) is not sufficiently sensitive or specific [
1
]. According to the World
Health Organization (WHO) estimates, cervical cancer is among the highest morbidity-
and mortality-causing cancers, with 570,000 new cases annually. Reports by the WHO
showed that 77,348 of women affected by cervical cancer died in the recent past, making it
the second-highest mortality-causing cancer in India [2,3].
With a diverse genetic base and a resource-limited healthcare infrastructure, India has
a disproportionate burden and challenging disease pattern of cervical cancer, necessitating
the need to develop robust diagnostic tools to facilitate large-scale screening in order to
alleviate the clinical prognosis. The conventional approach for cervical cancer diagnosis
is time-consuming and expert-oriented and requires a specific set of resources, leading to
Appl. Sci. 2022, 12, 4661. https://doi.org/10.3390/app12094661 https://www.mdpi.com/journal/applsci
