Scientists better predict recurrence of prostate cancer for black patients, according to new study; land $3.2 million in federal grants to explore racial bias in cancer diagnosis using Artificial Intelligence, computational imaging
Scientists at Case Western Reserve University are using Artificial Intelligence (AI) to reveal apparent cellular distinctions between black and white cancer patients, while also exploring potential racial bias in the rapidly developing field of AI.
most recent published research asserts that AI
analysis of digitized images of cancer tissues reveals critical variations
between black and white male prostate cancer patients. The work also suggests
the new population-specific
information—in addition to image detail on tissue slides also analyzed by
computers—could substantially improve care for black patients with prostate
“On one level, we’re simply trying to understand and answer this question: Are there biological differences in the disease, in the cancer, that are a function of your ethnicity or your race?” said Anant Madabhushi, the F. Alex Nason Professor II of Biomedical Engineering at Case Western Reserve and senior author on a study published March 5 in Clinical Cancer Research, a journal of the American Association for Cancer Research. “In other words, is there something else going on that can’t be explained by other disparities? The answer appears to be, ‘yes.’”
new work on prostate cancer builds on mounting evidence
that clear biological differences between races can be discovered at a cellular
level in the analysis of cancer cells—information which can be useful to tailor
medical care to specific groups and individuals within those populations.
$3.2M in three new grants from the Department of Defense
Madabhushi and his lab, along with collaborators from the Case Western Reserve School of Medicine, University of Washington Seattle and Perelman School of Medicine at the University of Pennsylvania, have also been awarded $3.2 million in three grants from the U.S. Department of Defense to assess biological differences in prostate and breast cancers between black and white patients:
Sanjay Gupta, the Carter Kessell Associate Professor of Urology at the Case Western Reserve School of Medicine, and Madabhushi were awarded $1.6 million to study how AI might be used to explore differences at the morphologic and molecular level of prostate cancer between black and white men.
Implicit in all of the ongoing research,
Madabhushi said, is the larger question about whether the racial differences
being discovered at the cellular level are revealing a research bias at the
“Even as we do this groundbreaking
research, we can’t allow ourselves to get trapped into trusting these models
blindly,” he said, “so we need to question whether we are considering all
populations (and) ask how diverse our research pool is.”
Prostate cancer study
differences were a key component in the most recent research work. The prostate
cancer study was performed over three years at
six sites and involved nearly 400 men with the disease.
One of the critical questions in
management of prostate cancer patients is to identify which men following prostate
surgery are at higher risk of disease recurrence and could benefit from
The patient pool in this study, however,
was about 80% white and 18% black, “so the model was biased toward the majority
population,” Madabhushi said. “Once we found the variations, applying the model
to all would be doing a disservice to that one population.”
researchers created a race-specific model, the accuracy in determining which
black patients would have a recurrence of the cancer increased six-fold,
previous cancer research led by Madabhushi’s lab, the scientists asked the
computer to look for patterns not only from images of the tumor itself, but at
tissue outside the tumor, known as
doing so—in this and other cancer studies—they have been able to successfully
tell, among other things, which patients would respond well to chemotherapy,
immunotherapy or even, in some cases, whether cancer would return or how long a
patient might live.
Aside from non-melanoma skin cancer, prostate cancer is the most common
cancer among men in the United States and one of the leading causes of cancer
death among men of all races, according to the Centers for Disease Control.
Further, while surgical resection of the prostate—known
as a radical prostatectomy—is performed for about 75,000 newly diagnosed
patients each year, 30% to 40% will see the cancer return, Madabhushi said.
this case, armed with the knowledge of which patients had a recurrence of the
cancer, scientists were able to retroactively see visual signals in tissue
slides from their initial diagnosis to determine which patients would suffer
Lead authors who collaborated with Madabhushi on the paper included Hersh Bhargava, a PhD student at the University of California-San Francisco, and Patrick Leo, a graduate student of biomedical engineering at Case Western Reserve University.
Bhargava said the researchers were able to “look at, and actually measure, hundreds of thousands, even millions, of cancer cells to see features that a human could never see—including structural characteristics.”
“It’s clear from the existing scientific literature that there are racial disparities in all cancers, but it appears that especially in prostate cancer that those differences can’t be explained by access to care or socioeconomic status—but rather that there is a biological component to how the cancers manifest differently between black and white patients.”
Leo said that the research was focused on a population-disparities element that has not been recognized until now in what he called the “AI-for-health space.”
“We know now that the risk is that if you just build a model for all patients, you will actually perform worse for patients in the minority and that’s something we cannot accept, even if it’s not something we did intentionally. So, if you want a model to work on patients from all populations, you have to deliberately include a population-specific aspect.”