[HN Gopher] AI used for skin cancer checks at London hospital
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       AI used for skin cancer checks at London hospital
        
       Author : chris_overseas
       Score  : 55 points
       Date   : 2025-04-12 07:43 UTC (2 days ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | xenospn wrote:
       | Why go to the hospital at all? Just take the photo at home.
        
         | harvey9 wrote:
         | Article says medical photographers take the pictures. I'd guess
         | a future iteration will have the app direct the patient to take
         | the pictures.
        
         | onename wrote:
         | I assume if you get a positive response you will want to speak
         | with doctor about it
        
           | zamadatix wrote:
           | If the thermometer says 39 C/102 F I will want to speak with
           | a doctor about it but that doesn't mean I want to go to the
           | hospital every time I want my temperature checked.
           | 
           | I suspect it has a lot more to do with these lines:
           | 
           | > medical photographers taking photos of suspicious moles and
           | lesions
           | 
           | I.e. it might not be ready enough or validated for an average
           | person snapping their own photo and:
           | 
           | > The images are then transferred to a desktop computer for
           | greater analysis before the tool determines the result
           | 
           | There is more to it than the phone app and it may not be
           | packaged in a way that is currently worthwhile to distribute
           | to home users.
           | 
           | Both of these (and other things) may change with time of
           | course.
        
         | charleshn wrote:
         | As someone with a phenotype more subject to skin cancer, I have
         | been using an app called SkinVision for years.
         | 
         | From my anecdotal experience it tends to flag the same moles as
         | dermatologists do, and they have actual dermatologists review
         | images where the model has low confidence, so overall pretty
         | happy with it.
         | 
         | Note that I am not affiliated with them in any way.
        
           | shermantanktop wrote:
           | Looks like it's not available in the US unfortunately.
        
           | asdefghyk wrote:
           | Interesting information snipped from their website .... I'm
           | in Australia so will try it out. Yes specifically says its
           | not available in US
           | 
           | About SkinVision SkinVision was founded in 2012 and provides
           | a mobile phone application, which supports individuals with
           | the early detection of the most common forms of skin cancer
           | (melanoma, squamous cell carcinoma, basal cell carcinoma, and
           | precancerous actinic keratosis). SkinVision is the first CE
           | marked skin cancer application based on extensive clinical
           | trials, conducted in partnership with Erasmus Medical Center
           | (EMC) and the university clinic of Ludwig Maximilian
           | University (LMU). Research shows the app has a sensitivity of
           | 95% and a specificity of 78%. The SkinVision app is
           | commercially available worldwide on iOS and Android except
           | for a few countries, such as the United States and Canada.
           | SkinVision is based in Amsterdam, the Netherlands.
           | 
           | The SkinVision Service is a Medical Device and is registered
           | with the Australian Therapeutic Goods Administration (TGA).
        
         | ajb wrote:
         | Because you don't know what the lighting is, what the sensor
         | is, and what kind of shit the camera app and ISP are doing to
         | the image without telling you
         | 
         | I recently tried to show some images to a vet. Something in my
         | phone fucked up the amount of red in the image, making them
         | useless (guess what, figuring out how much blood is present is
         | pretty important for medical applications)
         | 
         | Probably at some point we will all have a separate medical
         | camera with specified response and with a specified led
         | illuminator. Apple will probably get their phone certified in
         | some medical camera mode. Right now I don't think phone cameras
         | can be trusted
         | 
         | Not all applications need accurate colour, (no idea about
         | cancer checks) but some really do.
        
         | darrenf wrote:
         | 4 years ago I had my partner take photos of moles that had
         | changed colour on my back. I used the MySkinDoctor app
         | https://www.myskindoctor.co.uk/ to send them to my consultant
         | dermatologist (who, at the time, I had never met -- having just
         | moved to a new area). Upon review they arranged for an in-
         | person appointment and I was seen within a week or so. All
         | through the NHS.
         | 
         | So yes, taking the photo at home is perfectly doable. I still
         | went to hospital though.
        
           | graemep wrote:
           | I develop the backend for that. Nice to hear it worked well
           | for you.
        
         | ipsum2 wrote:
         | Google announced this in 2021, but never released it AFAICT:
         | https://blog.google/technology/health/ai-dermatology-preview...
        
         | stubish wrote:
         | One of the problems with these sorts of machine learning
         | applications, including this exact use case elsewhere, is that
         | they have been extremely sensitive to the imaging equipment
         | used. Train it on a dataset of images from one source and it is
         | only accurate on images from that source. Possibly only
         | accurate on images from the exact same device. For home use, it
         | needs a huge training set of images taken by all sorts of
         | devices in all sorts of lighting conditions. And then the
         | system will need to be improved until the error rates become
         | useful.
        
       | floppydiscen wrote:
       | This would be such a beautiful use of AI
        
         | ProllyInfamous wrote:
         | I last heard it's _a pretty darn helpful tool_ , from a
         | radiologist acquaintence/undergrad friend (who works from home
         | in USA).
        
       | andy99 wrote:
       | 99% accuracy in diagnosing benign case
       | 
       | This is meaningless. The only thing that matters in this kind of
       | application is false negative rate at some acceptable false
       | positive rate.
       | 
       | I assume whoever is working on this knows that, so this is mostly
       | a criticism of the article. That said, this is a horrible use of
       | AI.
        
         | greazy wrote:
         | I went searching for more. The tool is called DERM by Skin
         | Analytics. They have more info on stats:
         | 
         | https://skin-analytics.com/ai-pathways/derm-performance/
         | 
         | A few peer reviewed pubs down the bottom of the page
        
         | frereubu wrote:
         | What do you mean by this being a "horrible" use of AI?
         | (Although as another commenter has mentioned, this should more
         | properly be called ML).
        
           | jampekka wrote:
           | It's quite easy to correctly classify 100% of benign cases as
           | benign.
        
         | flir wrote:
         | Not really. It allows you to order your cases from most-likely
         | to least-likely, and get human eyeballs on the most-likely
         | cases first.
        
         | Spooky23 wrote:
         | It's really all about the protocol. AI tends to spot things
         | that doctors don't, and vice versa. Dermatology is also an area
         | being pillaged by private equity and access is poor for many
         | people.
         | 
         | I lost my wife to melanoma. She noticed a lesion within days of
         | it appearing, and a doctor saw it within 48 hours and felt it
         | was benign. My wife didn't accept it and had a plastic surgeon
         | remove it and biopsy, then had a margin removed by surgical
         | oncologist, the standard of care at the time. It came back as a
         | brain tumor 4 years later and she was gone in 6 months, even
         | with the incredible advancements today.
         | 
         | So I'd hold the position strongly that anything that improves
         | overall detection rates and access to care is incredibly
         | important and will save lives. Weeks matter with melanoma.
         | Today with immunotherapy Molly would be fine. But if she hadn't
         | advocated and gotten the original thing removed, it would have
         | cost her 4 important years.
        
           | tomcam wrote:
           | So sorry, brother.
        
           | asdefghyk wrote:
           | I've been told the only way to be sure if skin cancer or not
           | , is a biopsy. I also have been told ... not skin cancer...
           | but Dr decided to send me to a dermatologist. Is thing he
           | said when say it .. is looks like skin cancer ... lets take a
           | biopsy now ... to check . It was skin cancer ... a BCC
        
       | greazy wrote:
       | This is ML. I guess AI term can apply here but I think it's a bit
       | disingenuous to advertise as such. People will conflate the term
       | with llm chat bots.
       | 
       | https://skin-analytics.com/wp-content/uploads/2024/06/Artifi...
        
         | verst wrote:
         | What is AI to you? Neural nets only? LLMs?
         | 
         | I still have my textbook from almost 20 years ago: "Artificial
         | Intelligence: A modern" by Peter Norvig. Lots of topics covered
         | as AI there that surely do not meet your definition.
        
           | consp wrote:
           | AI is buzzword bingo and has been since introduced to
           | computing in the 60's.
           | 
           | Just clasify the method used as what it is to a supposedly
           | educated crowd. There is no need to classify a marketing
           | term. And yes, for that book it's also just marketing.
        
       | ircshotty wrote:
       | Anecdotally, when I had a potential skin cancer checked at a
       | London hospital they were completely ill-prepared.
       | 
       | When I came back to Australia, it was checked and immediately
       | removed as an obvious melanoma.
       | 
       | Perhaps the idea of Comparative Advantage also applies to
       | healthcare between countries with natural variances to types of
       | disease?
        
         | frereubu wrote:
         | Being a pasty Brit, going to Australia was a real eye opener in
         | how much more on the ball they were about skin cancer, not just
         | in medical terms but culturally. We're getting better here (I
         | was there more than a decade ago) but it's still seen as quite
         | amusing when people get sunburnt here.
        
           | femto wrote:
           | Awareness started in the 1980s in Australia with Sid the
           | Seagull:
           | 
           | https://www.youtube.com/watch?v=tGgn5nwYtj0
           | 
           | https://www.abc.net.au/btn/classroom/sun-safety-
           | campaign/103...
        
         | qq66 wrote:
         | Sadly, a friend of mine died from this type of problem. He
         | traveled from Ghana to Jordan and fell ill in Jordan, the
         | Jordanian doctors didn't diagnose it as malaria in time to save
         | him because Jordan doesn't have malaria. I'm sure it would have
         | been obvious to a Ghanaian doctor.
        
           | Scoundreller wrote:
           | Friend did a lot of work in Africa. Got back to the US and
           | starts getting symptomatic and says to himself "I think I got
           | malaria".
           | 
           | Goes to the biggest university hospital nearby he can find.
           | 
           | Was initially dismissed but waited it out for the infectious
           | diseases specialist and they quickly agreed with his self-
           | diagnosis.
           | 
           | They kept them in hospital for a few days so a parade of
           | clinical students/residents could come by for the specialist
           | to say: "this man has malaria"
        
             | ghaff wrote:
             | I came back from Bali and shortly after came down with a
             | really high fever when I was on vacation in Maine. When I
             | got home week later called my primary as I was still
             | running a bit of a fever and got blood work which was
             | pretty bad. Went to ER and my primary care figured it was
             | something tick related. The infectious disease guy on call
             | immediately identified as Dengue Fever. At the end,
             | including sending blood to the Louis Pasteur Institute in
             | Paris I spent something south of $1K to get told I'd
             | recover on my own--the Paris tests came back like weeks
             | later--and there really wasn't much they could do.
        
         | asdefghyk wrote:
         | Australia, Queensland, Brisbane has the highest incidence of
         | skin cancer in World. So Drs and dermatologists would have more
         | experience detecting it here. UV is probably much less intense
         | in England . This link graph shows skin cancer is over 2x in
         | Australia
         | https://www.statista.com/statistics/1032114/countries-with-t...
        
         | Tade0 wrote:
         | It's even more granular than that.
         | 
         | My neighbour who is a doctor moved to another city because
         | that's where he managed to get a spot to train for his field.
         | 
         | It appears that he's learning much more there than he would
         | back home because in this country some procedures are rare
         | outside of his current location.
        
       | timewizard wrote:
       | > The hospital gets about 7,000 urgent skin cancer referrals each
       | year, but only 5% turn out to be cancer.
       | 
       | It seems to be that you could be doing a _much_ better job of
       | filtering this pipeline before it gets to this point. How can so
       | many _urgent_ cases end up being negative?
       | 
       | They're using AI to solve a problem that probably shouldn't
       | exist.
        
         | RobinL wrote:
         | The referral is just because a non expert can't be sure. The
         | cost of the referral is relatively small, but the cost of
         | getting it wrong is large.
         | 
         | Someone I know recently had a referral - it's pretty light
         | touch, you just get a prompt appointment, and they do a minor
         | op to remove the mole, and send it to the lab for testing.
         | Luckily in their case, it wasn't cancer. But nothing in the
         | process seemed weird, it was just the way of the GP escalating
         | it because they couldn't be sure. Hypothetically, if the AI had
         | been able to diagnose with higher certainty than the GP, all of
         | this could have been avoided, so definitely room for
         | improvement.
        
           | alistairSH wrote:
           | Do all cases in the UK start with a GP? No ability to go
           | straight to a dermatologist? And are all dermatologists based
           | out of hospitals?
           | 
           | In the US, we'd just go straight to a dermatologist, who
           | would either remove it on the spot, or for a location that's
           | liable to scar badly, refer to a specialist surgeon. For
           | somebody fair skinned with lots of sun damage like myself,
           | it's an annual "ritual".
        
             | mattlondon wrote:
             | Most UK health stuff starts with a GP appointment.
             | 
             | Even for private health care, you usually see a GP first
             | (could be a private GP or NHS, in-person or video) and they
             | then refer you to the next thing whatever that may be. (
             | N.B. that a NHS GP can give you a referral that you use for
             | private treatment)
             | 
             | There are some things you can just straight up book an
             | appointment for yourself without a referral from a GP, but
             | 95% of the time you start with a GP.
             | 
             | No idea specifically about dermatologists, but my
             | expectation would be that would be the sort of thing that
             | would need a referral for. Perhaps for some "non-medical"
             | procedures and 100% for cosmetic procedures you don't need
             | a referral, but anything even tangentially close to The C
             | Word would almost certainly be sending you down the normal
             | channels.
        
         | alistairSH wrote:
         | And why are skin cancers being referred to a hospital at all?
         | 
         | Personal experience in the US... treatment can be done on the
         | spot at the primary dermatologist's office (curettage usually)
         | or referred either to a Mohs specialist or a plastic surgeon
         | (both of whom usually treat at their office). Short of a
         | melanoma that's progressed/metastasized, I don't think I've
         | ever heard of a skin cancer being treated at a hospital (not
         | saying it doesn't happen, only that that would be an exception,
         | based on personal/family/friend experiences).
        
           | pixl97 wrote:
           | I don't really know anything about the UK medical system, but
           | my guess is comparing it with how the US works isn't a good
           | fit.
           | 
           | Just doing a quick google search on dermatologists in the UK
           | mostly pointed at hospitals that offered the service, so may
           | have something to do with that.
        
       | rplnt wrote:
       | This doesn't seem like nothing new? I remember a talk about this
       | being done some 12+ years ago. Just without the AI label to
       | generate hype.
        
         | Legend2440 wrote:
         | There has been talk about this pretty much since CNNs got good
         | at object recognition ~2012.
         | 
         | But healthcare is a rather conservative industry (for good
         | reason) so it has taken a while to build confidence in the
         | technology and get regulatory approval.
        
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