Using online search activity for earlier detection of gynaecological malignancy

Abstract Despite major advances in precision treatments and new biomarkers, only 55% of UK cancers are detected at an early stage. Ovarian cancer (OC) remains the most lethal gynaecological malignancy with survival, quality of life, and fertility implications, as most women present with advanced stage disease. Endometrial cancer (EC) is the most common gynaecological malignancy, with an incidence that is rising exponentially. Unfortunately, an effective screening program does not exist for EC and OC, to facilitate early detection. Conventional healthcare cannot facilitate real-time monitoring of an individual’s health risks. However, digital footprints (e.g. online search activity) with their temporally dense nature could enable regular ‘health’ monitoring. The utilisation of online search data to identify those at risk of specific diseases has been suggested in other studies but were based on individuals with a proxy diagnosis, inferred through online search patterns, rather than confirmed clinical diagnosis. We evaluated the use of online search data to detect gynaecological cancer in individuals with a known confirmed diagnosis. There was a difference in online search patterns between those with benign and malignant diagnoses, as early as 360 days prior to primary care (GP) referral with a suspected cancer. A classification model based on online search data achieved its highest AUC (0.82) using data 60 days before the GP referral, in individuals who routinely performed health-related online search queries. Our experiments indicate that online search data could provide individualised gynaecological cancer risk profiles, which are not reliant on individuals recognising key symptom patterns. Online search data could provide an accessible disease screening tool to facilitate the earlier detection of gynaecological malignancy, complementing currently established approaches. More generally, we advocate that online search data could provide early insights into numerous conditions including a range of cancers.