Attention-Guided Fair AI Modeling for Skin Cancer Diagnosis

TL;DR

This paper introduces LesionAttn, a fairness-aware AI model for skin cancer diagnosis that reduces gender bias by focusing on lesion regions, balancing fairness and accuracy through Pareto optimization, validated on large datasets.

Contribution

The study presents LesionAttn, a novel attention-guided algorithm that incorporates clinical knowledge to mitigate gender bias in dermatological AI models.

Findings

LesionAttn reduces gender bias significantly.

LesionAttn maintains high diagnostic accuracy.

Outperforms existing bias mitigation methods.

Abstract

Artificial intelligence (AI) has shown remarkable promise in dermatology, offering accurate and non-invasive diagnosis of skin cancer. While extensive research has addressed skin tone-related bias, gender bias in dermatologic AI remains underexplored, leading to unequal care and reinforcing existing gender disparities. In this study, we developed LesionAttn, a fairness-aware algorithm that integrates clinical knowledge into model design by directing attention toward lesion regions, mirroring the diagnostic focus of clinicians. Combined with Pareto-frontier optimization for dual-objective model selection, LesionAttn balances fairness and predictive accuracy. Validated on two large-scale dermatological datasets, LesionAttn significantly mitigates gender bias while maintaining high diagnostic performance, outperforming existing bias mitigation algorithms. Our study highlights the potential of embedding clinical knowledge into AI development to advance both model performance and fairness, and further to foster interdisciplinary collaboration between clinicians and AI developers.