Rowena Yip | Searcharxiv

arXiv2026

Extending the Horizon of Early Diagnosis: Lung Cancer Prediction with Vision Transformers

Lung cancer remains a leading cause of cancer-related mortality worldwide, and early diagnosis is critical for improving survival. However, early-stage malignancies can be subtle on chest X-rays, creating challenges for radiologists. This study evaluates Vision Transformers (ViTs) for predicting lung cancer one to two years before clinical diagnosis. We analyzed 259,361 chest X-rays from 91,020 imaging studies at the Jamaica Plains VA Hospital in Boston, MA. The dataset showed extreme class imbalance, approximately 1:150 cancer to non-cancer, which was addressed using hybrid under- and over-sampling and class-weighted loss optimization. Three ViT configurations were evaluated: a model trained from scratch, an ImageNet-pretrained model, and a Corona-pretrained model fine-tuned on the lung cancer dataset. Transfer learning improved performance, with pretrained models exceeding the scratch baseline by 6-10 percentage points in AUC and about 10-12 percent in balanced accuracy. ImageNet-pretrained models showed the most stable overall performance, while Corona-pretrained models achieved higher sensitivity in some settings but greater variability. Moderate resampling ratios, including 1:1 undersampling and 1.5:2 oversampling, provided favorable trade-offs between sensitivity, precision, and computational efficiency, reducing runtime by up to 70 percent without major performance loss. These findings demonstrate the potential of ViTs for early lung cancer risk prediction from routine chest X-rays. Although performance remains below clinical deployment thresholds, the results support further development of ViT-based triage systems to flag high-risk patients for earlier evaluation.

cs.CV↗

arXiv2025

HEMERA: A Human-Explainable Transformer Model for Estimating Lung Cancer Risk using GWAS Data

Lung cancer (LC) is the third most common cancer and the leading cause of cancer deaths in the US. Although smoking is the primary risk factor, the occurrence of LC in never-smokers and familial aggregation studies highlight a genetic component. Genetic biomarkers identified through genome-wide association studies (GWAS) are promising tools for assessing LC risk. We introduce HEMERA (Human-Explainable Transformer Model for Estimating Lung Cancer Risk using GWAS Data), a new framework that applies explainable transformer-based deep learning to GWAS data of single nucleotide polymorphisms (SNPs) for predicting LC risk. Unlike prior approaches, HEMERA directly processes raw genotype data without clinical covariates, introducing additive positional encodings, neural genotype embeddings, and refined variant filtering. A post hoc explainability module based on Layer-wise Integrated Gradients enables attribution of model predictions to specific SNPs, aligning strongly with known LC risk loci. Trained on data from 27,254 Million Veteran Program participants, HEMERA achieved >99% AUC (area under receiver characteristics) score. These findings support transparent, hypothesis-generating models for personalized LC risk assessment and early intervention.

cs.LG↗