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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we highlight another potential medical benefit of artificial intelligence, this time in predicting breast cancer risk without the racial bias inherent in current assessments. We also report on a study that found physical changes in the ear and brain of those who suffer from tinnitus. And we cover a report that suggests women with abnormal cells on their cervix might do well to have them removed to lessen the risk of cervical cancer. 

In breaking news, see these stories from our Reuters journalists: World at risk of losing malaria fight as cases rise, report says; U.S. probes quality issues with China-made plastic syringes; Turkey launches investigation into 19 pharma companies; U.S. EPA proposes replacing lead water pipes within 10 years; Jordan to host conference to coordinate aid to Gaza; U.S. life expectancy climbs in 2022 after COVID retreat; and China launches probe into surrogacy, fake paternity tests in Wuhan.

Using mammogram data from thousands of racially diverse women, researchers have developed an artificial intelligence tool that predicts women’s risk of breast cancer without the racial bias inherent in traditional risk scores. (In this photo, a patient prepares to undergo a mammogram at the Kenyatta National Hospital in Nairobi, Kenya.) REUTERS/Njeri Mwangi

An artificial intelligence (AI) tool developed using only mammogram image information accurately predicts breast cancer risk without racial bias, researchers reported on Wednesday in Chicago at the Radiological Society of North America meeting.

Traditional breast cancer risk assessment formulas use information obtained from patient questionnaires, such as medical and reproductive history, to calculate a patient’s future risk of developing breast cancer.

“Traditional models likely have racial biases due to the populations on which they were developed,” study leader Dr. Leslie Lamb of Massachusetts General Hospital in Boston said in a statement. “Several of the commonly used models were developed on predominantly European Caucasian populations.”

According to the American Cancer Society, Black women have the lowest five-year survival rate for breast cancer among all racial and ethnic groups.

The new model was developed using 129,340 routine screening mammograms performed in 71,479 women between 2009 to 2018, including 106,839 exams in white women, 6,154 exams in Black women, and 6,435 in Asian women.

The AI tool consistently outperformed traditional risk models in predicting the risk of developing early-stage ductal carcinoma in situ (DCIS) and invasive breast cancer over the next five years, regardless of race.

“The model is able to translate the full diversity of subtle imaging biomarkers in the mammogram, beyond what the naked eye can see, that can predict a woman’s future risk of both DCIS and invasive breast cancer,” Dr. Lamb said. “The deep learning image-only risk model can provide increased access to more accurate, equitable and less costly risk assessment.”

People with tinnitus, an annoying ringing in the ears, have nerve damage and other physical changes in the ear as well as increased brain activity to try to compensate, researchers reported on Thursday in Scientific Reports.

The researchers studied 294 volunteers, a group that included people who had never experienced tinnitus, some who said they had a brief bout of tinnitus in the past, and those  who reported continuous tinnitus for more than six months.

People reporting current chronic tinnitus had loss of fibers in their cochlear nerves, which are responsible for transmitting information from the inner ear to the brain. They also had increased activity in the brainstem as it tried to compensate for the nerve-damage associated hearing loss.

Chronic tinnitus sufferers also had abnormal reflexes in the muscles and nerves in the middle and inner ear, affecting sound processing.

“Beyond the nuisance of having persistent ringing or other sounds in the ears, tinnitus symptoms are debilitating in many patients, causing sleep deprivation, social isolation, anxiety and depression, adversely affecting work performance, and reducing significantly their quality of life,” study leader Stephane Maison of Mass Eye and Ear in Boston said in a statement.

“We won’t be able to cure tinnitus until we fully understand the mechanisms underlying its genesis,” Maison said.

Developing ways to check for cochlear nerve deficits and clarifying how they cause tinnitus will be key to developing treatments “designed to rebuild a damaged inner ear and perhaps reverse the tinnitus,” the  researchers concluded.

Some women with abnormal cells on their cervix that could develop into cancer might be better served by removal of those cells, or by longer-term monitoring, than by a less aggressive approach, a new study suggests.

In cases in which abnormal cells affect one to two thirds of the cervix, the risk of cervical cancer nearly quadruples over the next few decades when patients are managed with “active surveillance,” or biopsies at regular intervals, instead of immediate surgery, researchers reported on Wednesday in The BMJ.

The risk that those cells will turn into cancer is often quite low. Earlier research had shown that in women like those in this study, who had so-called cervical intraepithelial neoplasia grade 2 (CIN2) affecting one to two thirds of the cervix, the condition often regresses on its own within two years. Many doctors therefore offer two years of monitoring as an option for these women.

To understand whether this approach is associated with increased risk of cervical cancer in the longer term, researchers tracked 27,524 women with grade 2 CIN, roughly half of whom had two years of active surveillance. The others had an immediate procedure to remove the abnormal cells.

During the first two years, the odds of being diagnosed with cervical cancer were roughly equal in the two groups. And over 20 years, the absolute risk of developing cervical cancer was only about 0.8%. But the risk in the women who didn’t have immediate surgery rose to 2.65% over the two decades of the study.

The researchers did not have access to all the factors that might have influenced the results, such as the women’s socioeconomic status or the number of biopsies in the active surveillance group.

Still, they said, their findings are important for decision-making by women with CIN2 and suggest a need for increased follow-up of women who were previously managed with active surveillance.

This newsletter was edited by Bill Berkrot.

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