Colposcopes and digital cervical screening devices (DYSIS, EVA System, AVE)

A colposcope is a low-power binocular microscope with a bright light, used at arm's length to inspect the cervix after acetic acid is applied; abnormal areas turn white and are biopsied or treated by excision. Optical colposcopes from Zeiss, Leisegang (CooperSurgical) and others remain the reference, increasingly with digital cameras for records and teaching. Digital devices try to make the judgement more objective and portable: DYSIS Medical's system maps how quickly the acetowhitening fades at each point and colours the image accordingly; MobileODT's EVA System is a smartphone-based colposcope with cloud image review and an AI score; the Pocket Colposcope developed at Duke fits inside a speculum for self- or nurse-led imaging; and the automated visual evaluation algorithm developed with the US National Cancer Institute reads cervical images to triage HPV-positive women where cytology and colposcopists are scarce. These matter because the WHO cervical cancer elimination strategy asks for HPV screening and treatment of positive women in countries with very few colposcopists.

Digital tools inherit colposcopy's limits: sensitivity for high-grade disease is modest and depends on training, acetowhitening is non-specific, and AI scores need validation on the populations and cameras where they are deployed. They add cost and connectivity requirements but can bring the examination to primary care.