Lung Cancer Detection Using Bayesian Networks: A Retrospective Development and Validation Study on a Danish Population of High‐Risk Individuals

ABSTRACT Background Lung cancer (LC) is the top cause of cancer deaths globally, prompting many countries to adopt LC screening programs. While screening typically relies on age and smoking intensity, more efficient risk models exist. We devised a Bayesian network (BN) for LC detection, testing its...

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Main Authors: Margrethe Bang Henriksen, Florian Van Daalen, Leonard Wee, Torben Frøstrup Hansen, Lars Henrik Jensen, Claus Lohman Brasen, Ole Hilberg, Inigo Bermejo
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Cancer Medicine
Online Access:https://doi.org/10.1002/cam4.70458
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Summary:ABSTRACT Background Lung cancer (LC) is the top cause of cancer deaths globally, prompting many countries to adopt LC screening programs. While screening typically relies on age and smoking intensity, more efficient risk models exist. We devised a Bayesian network (BN) for LC detection, testing its resilience with varying degrees of missing data and comparing it to a prior machine learning (ML) model. Methods We analyzed data from 9940 patients referred for LC assessment in Southern Denmark from 2009 to 2018. Variables included age, sex, smoking, and lab results. Our experiments varied missing data (0%–30%), BN structure (expert‐based vs. data‐driven), and discretization method (standard vs. data‐driven). Results Across all missing data levels, area under the curve (AUC) remained steady, ranging from 0.737 to 0.757, compared to the ML model's AUC of 0.77. BN structure and discretization method had minimal impact on performance. BNs were well calibrated overall, with a net benefit in decision curve analysis when predicted risk exceeded 5%. Conclusion BN models showed resilience with up to 30% missing values. Moreover, these BNs exhibited similar performance, calibration, and clinical utility compared to the machine learning model developed using the same dataset. Considering their effectiveness in handling missing data, BNs emerge as a relevant method for the development of future lung cancer detection models.
ISSN:2045-7634