Automated Cervical Cancer Screening Framework: Leveraging Object Detection and Multi-Objective Optimization for Interpretable Diagnostic Rules

Cervical cancer is one of the most common malignant tumors, with high incidence and mortality rates. Recent studies mainly adopt Artificial Intelligence (AI) models to detect cervical cells. Yet, due to the imperceptible symptoms of cervical cells, there are three problems that may hinder the performance of the existing approaches: (a) poor quality of the whole-slide image (WSI) performed on cervical cells may lead to undesirable performance; (b) several types of abnormal cervical cells are involved in the progression of cervical cells from normal to cancer, which requires extensive clinical data for training; and (c) the diagnosis of the WSI is medical-rule-driven and requires the AI model to provide interpretability. To address these issues, we propose an integrated automatic cervical cancer screening (IACCS) framework. First, the IACCS framework incorporates a quality assessment module utilizing binarization-based cell counting and a Support Vector Machine (SVM) approach to identify fuzzy regions, ensuring WSI suitability for analysis. Second, to overcome the data limitations, the framework employs data enhancement techniques alongside incremental learning (IL) and active learning (AL) mechanisms, allowing the model to adapt progressively and learn efficiently from new data and expert feedback. Third, recognizing the need for interpretability, the diagnostic decision process is modeled as a multi-objective optimization problem. A multi-objective optimization algorithm is used to generate a set of interpretable diagnostic rules that offer explicit trade-offs between sensitivity and specificity. Extensive experiments demonstrate the effectiveness of the proposed IACCS framework. Applying our comprehensive framework yielded significant improvements in detection accuracy, achieving, for example, a 6.34% increase in mAP50:95 compared to the baseline YOLOv8 model. Furthermore, the generated Pareto-optimal diagnostic rules provide superior and more flexible diagnostic options compared to traditional manually defined rules. This research presents a validated pathway towards more robust, adaptable, and interpretable AI-assisted cervical cancer screening.