AI-Driven Research Uncovers Biological Factors Behind Higher Endometrial Cancer Mortality in Black Women

Endometrial cancer, the most common gynecological malignancy affecting over 66,000 women annually in the United States, exhibits notably worse outcomes in Black women, with an 80% higher mortality rate compared to other groups. This disparity persists regardless of socioeconomic status and healthcare access, prompting researchers to investigate underlying biological factors.

A team from Emory University sought to determine whether genetic and pathological differences contribute to the higher severity and poorer prognosis observed in Black women with endometrial cancer. Led by Anant Madabhushi, the researchers employed advanced artificial intelligence (AI) techniques to analyze tissue samples from African American and European American women diagnosed with the disease.

Their study, published in npj Precision Oncology, involved examining tissue slides to identify structural and microscopic features, including immune cell interactions and connective tissue characteristics. Using machine learning, they discovered distinct features associated with each racial group. The analysis revealed that in Black women, immune cells called lymphocytes interacted more with the stromal tissue, which provides structural support, whereas in white women, lymphocytes primarily interacted with epithelial tissue, the protective lining.

These differences influenced the predictive accuracy of risk models. When models incorporated data specific to Black women, they more accurately predicted the likelihood of adverse outcomes, emphasizing that tumor development and immune response vary across populations. This insight underscores the importance of personalized approaches in cancer prognosis and treatment.

The findings have significant implications for immunotherapy strategies, which harness the body's immune system to fight cancer. Recognizing racial-specific immune architecture differences may enable clinicians to design more effective, tailored immunotherapies for Black women, potentially reducing survival disparities.

Though the research does not fully explain all mechanisms of tumor development, it confirms that genetic and biological factors play a critical role in cancer progression. Madabhushi stresses the importance of studying these variations to improve outcomes and address health inequities.

This pioneering study showcases how AI can reveal crucial biological differences, guiding future research and clinical practices to create more equitable healthcare solutions.