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New AI tool could predict 5-year risk of getting lung cancer

A new artificial intelligence screening tool could predict a patient’s risk of getting lung cancer within five years and aid screening programmes.

A new artificial intelligence screening tool could predict an individual’s risk of getting lung cancer within five years compared to the best risk models available.

The model has been developed by researchers from UCL and the University of Cambridge and findings, published in PLOS Medicine, show it can predict five-year risk of lung cancer using just a quarter of the information usually needed.

The study used data from the UK Biobank and US National Lung Screening Trial to develop models to simplify the prediction of a person getting lung cancer within the next five years.

Datasets experimented with over 60 different machine learning pipelines to see which were the most effective at predicting lung cancer risk using just three variables – age, how many years the individual smoked for, and the average number of cigarettes per day.

From these, they selected four model pipelines and combined them into an ‘ensemble’ that was able to predict lung cancer risk with the same or improved accuracy, compared to the best available models currently is use. Importantly, they were able to achieve this accuracy using only a third of the variables, greatly simplifying the process of gathering the data required.

The authors hope the findings will be used to make any national lung cancer screening programme quicker, easier and cheaper to implement, while still achieving the primary aim of reducing lung cancer mortality.

Artificial intelligence and lung cancer risk

Dr Tom Callender (UCL Medicine), first author of the study, said: “Screening for cancer and other diseases saves lives and we are increasingly able to personalise this process. But such personalised screening and disease prevention programmes present important logistical challenges at scale. Our study shows that artificial intelligence can be used to accurately predict lung cancer risk using just three pieces of information that would be easy to gather during routine GP appointments, online or via apps. This approach has the potential to greatly simplify population level screening for lung cancer and help to make it a reality.”

The models used in the study were externally validated in the US Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and benchmarked against models that are either in use or have performed strongly in previous analyses. The authors believe the same approach could be viable for simplifying screening process for other diseases, such as type-2 diabetes and cardiovascular disease.

Professor Mihaela van der Schaar, an author of the study from the University of Cambridge, added: “This research is a prime example of how machine learning tools such as AutoPrognosis, combined with innovative clinical researchers, can make a real impact in healthcare at a population level. While AutoPrognosis has already been applied for risk prediction and prognosis in numerous diseases, this is the first time it has been used to determine the minimal information needed to screen patients. I think this is the future of preventive medicine and I’m optimistic that the same approach could be applied to screening for other diseases.”

Lung cancer is the most common cause of cancer death worldwide, with poor survival in the absence of early detection. It is estimated that there were 1.8 million lung cancer deaths globally in 2020.

Screening for lung cancer amongst those at high-risk could reduce lung cancer-specific mortality by 20-24% amongst those screened, but the ideal way to determine if someone is high-risk remains uncertain and existing approaches are resource intensive.

This work was supported by Wellcome, the National Science Foundation, the Medical Research Council and Cancer Research UK.

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