AI-Based Detection of Colorectal Cancer in Primary care

Period
July 2024 – June 2025

Objective
This project aims to develop a Risk Prediction Tool to use as an early warning system in primary care, aimed at cancer using Colorectal Cancer as the first test case. The tool will be based on data collected at primary care units, such as care visits such as history, symptoms, medication, lab tests and results, as well as free text from physician notes. The tool will use machine learning (ML), large language models and advanced statistical analyses to assess the risk of patients having an underlying yet undiagnosed CRC. Despite the promise and potential of primary care data to assess risk and improve screening, very few studies use this potential to better inform diagnostics.

Existing risk assessment tools designed for use in primary care have been developed and validated with a limited dataset (ICD-10 codes that were present in primary care datasets, covering a smaller percentage of patients), but are not yet in clinical use. The project aims to gain an understanding of the most salient data points for assessing risk of CRC in primary care, as well as insight into the potential benefits of such analysis for the healthcare system. Through this analysis, the project also aims to obtain a validated, novel risk prediction tool for CRC, which can be widely deployed and feed into national guidelines for colorectal cancer. By using CRC as the initial test case, the project aims to develop methods and tools through the results of the project which can be modified for other cancers and applications.

Background
A majority of patients with cancer present with early symptoms in primary care, before receiving their diagnosis. Despite the fact that Sweden has fast track for cancer diagnosis since 2015 (cancer care pathway, CCP) primary care physicians lack decision support to assess cancer risk for individual patients. Colorectal cancer (CRC) is the third most common cancer in Sweden. Despite screening, most patients with CRC are diagnosed after symptom presentation. The survival is excellent in patients diagnosed with CRC limited to the bowel wall (stage I-II) and intermediate when it has spread to regional lymph nodes (stage III) while the prognosis is poor in the approx. 25% who are diagnosed with CRC with distant metastases (stage IV).

Cross-disciplinary collaboration
The project is a highly inter-disciplinary collaboration between KTH, Regional Cancer Centrum Stockholm-Gotland, Regional Cancer Centrum Väst and Karolinksa Institutet. The project team comprises primary care clinicians, statisticians, modelers, software engineers and planners at RCC.