November is the month of male health awareness promoted by the MOVEMBER movement (contraction of the words "Moustache" and "November"). The Vall d'Hebron Research Institute (VHIR) investigates in the prevention and promotion of health in general and, in this case, of men in particular. Specifically, it participates in the TARTAGLIA project, which among its objectives is the study of artificial intelligence (AI) technologies to improve the treatment of prostate cancer and its early detection and the detection of the preliminary stages of neurodegenerative diseases of special incidence and prevalence, as is the case of Alzheimer's disease.

Early diagnosis of prostate cancer using artificial intelligence

Only four out of ten men visit a urologist at least once a year, and according to the Spanish Society of Medical Oncology report "Cancer figures in Spain 2022", 30,884 cases will have been diagnosed this year, with this type of tumour being one of the most numerous, only surpassed by colon, breast and lung cancers (in that order). These data justify the need to raise awareness among men about the need for screening from the age of 50 onwards, with the main objective of early detection and significantly improving the prognosis, both in terms of prevention and treatment, with the different techniques and therapeutic possibilities.

It is necessary to increase social awareness of this problem, and that is why MOVEMBER was created, in order to generate knowledge and exposure of the problem that would lead to action in the field of men's health. Such has been its success that it has managed to raise awareness and give visibility to men's health at an international level, as well as obtaining funding to develop more than a thousand research programmes on prostate cancer, testicular cancer, neurodegenerative diseases and the consequences of physical inactivity.

Another research project to tackle prostate cancer is TARTAGLIA, a project led by GMV to accelerate clinical and healthcare research by exploiting clinical data using AI. Specifically, this package focuses on aiding the diagnosis of prostate cancer.

The federated data analysis carried out in the framework of the TARTAGLIA project will make it possible to use multiple data sources in a federated network to predict prostate cancer from clinical, genomic and radiomic data (extraction of quantitative parameters using algorithms in medical images to detect and measure those characteristics that cannot be detected by direct observation, with the aim of associating them with specific clinical processes). All this makes it possible to predict the type and aggressiveness of the tumour and improve the categorisation of risk groups, allowing, in turn, to reduce or avoid invasive diagnostic procedures, and as in the previous case, to advance in personalised, predictive and precision medicine.

In the words of Dr. Joan Morote, head of the Biomedical Research in Urology group at VHIR and Professor of Urology at the Autonomous University of Barcelona, "the application of artificial intelligence technologies in the early diagnosis of prostate cancer, clinically significant in the federated TARTAGLIA network, will allow the design of new predictive algorithms that can improve the current diagnostic strategy and personalise the treatment of prostate cancer". At the same time, "its development and integration in federated networks is of great importance, as it will allow a qualitative leap in the generalisation of medical excellence, integrating massive data from various centres and generating common algorithms that improve risk prediction in each and every one of the centres, enabling the general implementation of personalised medicine".

Early detection of Alzheimer's disease from artificial intelligence data analysis with spontaneous language

Most studies in the population over 65 years of age estimate a prevalence of dementia between 4% and 9%, being higher in women in almost all age groups. At the same time, they also point to Alzheimer's disease as the most frequent cause of dementia (50-70% of the total). Similarly, results from two large Cognitive Function and Ageing Studies (CFAS) suggest that, over the past 20 years, the number of new cases of dementia fell by up to 20%, especially due to a reduction in the incidence among men over 65 years of age. According to experts, this can be explained by public health campaigns addressing cardiovascular disease and smoking (men tend to have heart disease at a younger age and smoke more than women), two risk factors for Alzheimer's disease.

This fact, like the previous case concerning prostate cancer, reinforces the importance of raising awareness for men's health care with initiatives such as the one launched by young Travis Garone and Luke Slattery in 2003, creators of MOVEMBER. With just 30 followers, the movement that began in Australia, a year later became the Movember Foundation, now present in 21 countries, including Spain.

Awareness is raised from different platforms about the importance of prevention and early detection, thanks to the application of advanced data analysis techniques and AI. This message is echoed by the TARTAGLIA project, which is also investigating multimodal AI techniques for the early detection of Alzheimer's, using the federated data network to develop and validate an algorithm capable of predicting that a person will suffer from Alzheimer's at any given time. The tool is expected to provide a multi-class classifier with a predictive diagnostic accuracy of close to 90%.

"One of the most interesting elements of this language exploration is that we carry it out comfortably and quickly, as the three tests we use to generate this large number of parameters are based on three very simple activities, such as describing an image in a free manner, which takes our patients only a few minutes", explains Sergi Valero, head of the Department of Medical Psychology at Ace Alzheimer Center, the entity that leads the work package for the early detection of Alzheimer's within the framework of the TARTAGLIA project.

"The aim we are pursuing is that, in the near future, thanks to artificial intelligence, we will be able to propose good predictors of the disease that involve a low consumption of resources and that are easy to obtain from any potential user," concludes Valero.

As the neurologist Mercè Boada, medical director of Ace Alzheimer Center Barcelona, points out, "there are not only more women with dementia than men: there are also more female caregivers than male caregivers, for example. And the majority of people with cognitive impairment who live alone are also women".

For this reason, experts agree on the need to detect dementia in the preclinical phase, as this ensures that the person affected can make decisions about their future in time. Dr. Boada also highlights the valuable contribution that AI offers in this field, as Valero pointed out, since within the framework of TARTAGLIA "the processing of spontaneous speech can provide a large number of parameters that, after being properly processed, can become a marker of cognitive deterioration of great interest in the identification of the initial stages of the disease".

All this, according to Boada, will improve "access to effective drugs if the disease is diagnosed early, facilitate access to clinical trials for those affected and reduce the economic impact associated with late diagnosis of Alzheimer's disease".

TARTAGLIA is part of the program R&D Missions in Artificial Intelligence of the Spain Digital Agenda 2025 and of the National Artificial Intelligence Strategy, funded by the European Union through the Next GenerationEU funds. The actions carried out will be reported to the Ministry of Economic Affairs and Digital Transformation (file number MIA.2021.M02.0005), corresponding to the funds of the Recovery, Transformation and Resilience Plan.