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Public Health

Latvia is among the countries with the highest rates of cervical cancer in Europe. There is currently no indication that the situation is set to improve in the near future. To tackle the problem and to significantly reduce incidence rates, the Institute of Public Health at Rīga Stradiņš University (RSU) and researchers Anda Ķīvīte-Urtāne, Una Kojalo and Jana Žodžika have started work on an international project to modernise the cervical cancer screening process.

The purpose of the screening is to detect precancerous pathological changes in the cervical tissues that without timely treatment could cause cancer. As part of this project, RSU will enter the world of artificial intelligence by helping to develop a special application that would warn users about the possibility of the disease.

The project is funded by the Iceland, Liechtenstein and Norway Grant of the Baltic Research Programme, and will run for four years. The project will be implemented by the University of Tartu as the lead partner as well as RSU, the Lithuanian University of Health Sciences and the Cancer Registry of Norway.


From data collection to artificial intelligence

Initially, national data collection and analysis will be carried out in all four countries involved in the project. According to researcher Ķīvīte-Urtāne, anonymised data from the National Health Service on women who have previously undergone examinations, as well as cases of the disease, would be used. Data collection and analysis has been going on in Norway since the early 1970s. The information and experience amassed over the years will be shared with the Baltic partners during the project.

Ķīvīte-Urtāne explains that the project is divided into several stages, each led by one of the partner countries. The Estonian partners will carry out the data collection and analysis. Using the collected data, a special algorithm will be developed with the help of the Norwegian partners, and using this algorithm a special application will be developed as a part of another stage of the project implemented by the Latvian partners. Ideally, this application will then help determine users’ risk to develop cervical cancer. Each user would enter personal information, for example any comorbidities, prescribed medication, occupation, and eating or exercising habits. Depending on the results of processing this information, the user might then receive an individualised recommendation to see a doctor.

Other forms of artificial intelligence also exist that could help reduce the number of people affected by these oncological diseases. According to researcher Kojalo, a routine screening of all women may not be necessary, but the focus should be on specific target groups created using a specific algorithm based on processing data. The project’s Lithuanian partners will study the cost-effectiveness of this type of screening, thereby assessing invested funding against the results obtained.

Why is the project important for Latvia?

Cervical cancer screenings were mandatory in the USSR. After the restoration of independence in the 1990s, there were initially no regular and compulsory examinations. They were recommended, but response rates were low and morbidity and mortality rapidly increased. Organised screenings were introduced in Latvia in 2009, however, attendance was, and still is low. According to some estimates the morbidity rate in Latvia is the highest in Europe. Estonia and Lithuania also have high levels. Ķīvīte-Urtāne explains that there is nationwide screening at the moment, but with little result. Few women go for these screenings even though personalised invitations are regularly sent out. Kojalo stresses that "in order for screenings to reduce the negative effects of this disease, participation rates should be 70-75%, but in Latvia today it is 45%." The purpose of regular examinations is to detect the disease early, at a pre-cancer stage, so that treatment can be started in time.

Ķīvīte-Urtāne explains that oncological diseases are the second most common cause of death in Latvia after cardiovascular diseases. The international project, in which RSU represents Latvia, is particularly important and will contribute to reducing the number of cancer cases. It will reduce the number of neglected cases, cases of delayed diagnosis, cases that cannot be cured without lasting consequences, and even fatalities. Reducing mortality rates will increase women’s life expectancy, improve quality of life, and promote healthy ageing.