- Pioneering study led by the University of Sheffield and funded by Cancer Research UK is examining the use of artificial intelligence to improve early detection of oral cancer
- The rate of people being diagnosed with oral cancers has increased by almost 60 per cent in the last 10 years
- Doctors currently predict the likelihood of pre-cancerous changes developing into cancer by assessing biopsies on 15 different criteria to determine whether action is needed and what treatment pathway should be taken
- This score is subjective, which means there are often huge variations in how patients with similar biopsy results are treated
Artificial intelligence can help doctors better predict the risk of patients developing oral cancer, new research from the University of Sheffield has revealed.
The pioneering study, funded by Cancer Research UK, is examining the use of machine learning and artificial intelligence (AI) to assist pathologists and improve the early detection of oral cancer.
The rate of people being diagnosed with oral cancers including mouth, tongue, tonsil and oropharyngeal cancer, has increased by almost 60 per cent in the last 10 years.
Evidence suggests tobacco and alcohol consumption, viruses, old age as well as not eating enough fruit and vegetables can increase the risk of developing the disease. Oral cancer is often detected late which means that the patient survival rates are poor.
Machine learning and AI can aid tissue diagnostics by removing subjectivity, using automation and quantification to guide diagnosis and treatment.
Dr Ali Khurram
School of Clinical Dentistry, University of Sheffield
Currently, doctors must predict the likelihood of pre-cancerous changes, known as oral epithelial dysplasia (OED), developing into cancer by assessing a patient’s biopsy on 15 different criteria to establish a score. This score then determines whether action is needed and what treatment pathway should be taken.
This score is subjective, which means there are often huge variations in how patients with similar biopsy results are treated. For example, one patient may be advised to undergo surgery and intensive treatment, while another patient may be monitored for further changes.
Dr Ali Khurram, Senior Clinical Lecturer at the University of Sheffield’s School of Clinical Dentistry, said: “The precise grading of OED is a huge diagnostic challenge, even for experienced pathologists, as it is so subjective. At the moment a biopsy may be graded differently by different pathologists, the same pathologist may even grade the same biopsy differently on a different day.
“Correct grading is vital in early oral cancer detection to inform treatment decisions, enabling a surgeon to determine whether a lesion should be monitored or surgically removed.
“Machine learning and AI can aid tissue diagnostics by removing subjectivity, using automation and quantification to guide diagnosis and treatment. Until now this hasn’t been investigated, but AI has the potential to revolutionise oral cancer diagnosis and management by ensuring accuracy, consistency and objectivity.”
Samples of archived OED tissue samples with at least five years of follow up data will be used in order to train AI algorithms and learn the statistical correlations between certain classifiers and survival rates.
These algorithms will aid pathologists in their assessment of biopsies helping them to make a more informed and unbiased decision about the grading of the cells and the patient’s treatment pathway. The proposed algorithms have a strong translational angle and a potential to be rapidly deployed as an aid to clinical and diagnostic practice worldwide.
“People often feel threatened by AI, however rather than replacing a doctor's expertise, exceptionally high-level of training and experience, the technology can help to assist their decision-making and compliment their skills,” said Dr Khurram.
“This will help them to give a more accurate assessment and enable them to recommend the most beneficial treatment pathway for individual patients which will hope will help to improve survival rates.”
The research is led by Dr Khurram at the University of Sheffield with Professor Nasir Rajpoot from the University of Warwick as the co-Principal Investigator. Other co-investigators and collaborators include Professor Hisham Mehanna and Dr Paul Navkivell from the University of Birmingham and Dr Jacqueline James from Queen’s University Belfast.
Professor Nasir Rajpoot, said: “We are very excited to work on this project with Dr Khurram and his team at Sheffield.
“Early detection of cancer is a key focus area of research in our lab and this award by CRUK adds to the portfolio of research at the TIA lab on early detection of cancer.
“The pilot project will pave the way towards the development of a tool that can help identify pre-malignant changes in oral dysplasia, crucial for the early detection of oral cancer. Successful completion of this project carries significant potential for saving lives and improving patient healthcare provision.”
November is Mouth Cancer Action Month. This yearly campaign aims to address and tackle the growing number of cases of mouth cancer in the UK. The Oral Health Foundation works to get more mouth cancers diagnosed at an early stage by raising awareness of the disease while encouraging everybody to be more vigilant about changes in their mouth.
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