By Dr Alan Smith, Specialist in Public Health Medicine, National Screening Service
In recent years the field of healthcare has experienced remarkable advancements, with one technology standing out as a disruptive and transformative force, Artificial Intelligence (AI). AI refers to the application of advanced technologies that mimic human intelligence and decision-making processes and can improve various aspects of healthcare. AI leverages what are called algorithms, machine learning, natural language processing and other cutting-edge techniques to analyse vast amounts of medical data, identify patterns, make predictions, and assist healthcare professionals in their decision-making processes.
The role of AI in cancer screening is evolving and rapidly so. Among the most promising breakthroughs is its potential use in population cancer screening programmes such as breast, bowel and cervical screening. AI technology, with its ability to analyse vast amounts of data quickly and accurately, far beyond human capability, can complement our traditional screening methods and brings several advantages with it.
AI algorithms can analyse medical imaging data such as mammograms, digital pathology, and digital imagery of the colon with a level of precision that complements human interpretation. AI can identify subtle abnormalities and patterns that might be missed by the human eye, leading to faster and earlier detection of cancerous lesions or precancerous changes. By minimising every population screening programme’s incidence of false negatives and false positives, AI can help reduce unnecessary follow-up tests and lead to more accuracy and precision. Truly exciting.
With our growing populations, ageing populations and limited staff resources, the integration of AI powered software into cancer screening programmes could automatically analyse screening results faster, flag the suspicious cases for human review and generate reports for healthcare professionals. This will allow our valuable healthcare professionals to prioritise and practice at the top of their license, allowing AI to ease the pressure on our overstretched healthcare system by driving workflow efficiencies. Hugely beneficial.
A major theme in population cancer screening is understanding and quantifying risk. By identifying high-risk individuals and prioritising screenings for them, AI can help to maximise the cost-effectiveness of population cancer screening programmes. By reducing unnecessary screenings for low-risk individuals, healthcare resources can instead be directed both toward those who would benefit most from early detection and other parts of our healthcare system. Maximises benefits.
However, it’s important to note that AI is not a replacement for medical professionals or medical scientists but rather a very powerful tool to augment their skills and abilities. Ethical considerations, data privacy and ongoing research are essential to ensure the responsible and beneficial integration of AI in cancer screening programmes. In Ireland, changes to population screening programmes involving AI is likely to require evaluation by the National Screening Advisory Committee (NSAC) before it makes a recommendation to the Minister for Health.
We already have an international reputation for innovation and adopting new technologies in Ireland’s population cancer screening programmes. BreastCheck was one of the first programmes in the world to transition to digital screening mammography in 2008. BowelScreen was at the vanguard with the adoption of the faecal immunochemical test (FIT) as the primary screening test in 2013. The introduction of HPV testing into CervicalCheck began in 2012 with post-treatment test of cure, followed by HPV triage of low-grade abnormalities in 2015, and full transition to primary screening with HPV completed in 2020, becoming one of the first programmes in the world to do so.
Cancer demands swift and accurate diagnosis to improve patient outcomes. We are fully committed to playing our part and leading from the front in terms of developments in our population screening programmes to prevent or recognise disease early. As outlined in our strategic plan, by the end of 2023 we will have mobilised a structured and routine horizon scanning project as part of our core public health function. Standing like a beacon on the horizon and heading rapidly in our direction is AI. It’s not a case of if but when.