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OPEN Performance of machine learning

algorithms for lung cancer
prediction: a comparative approach
Satya Prakash Maurya 1, Pushpendra Singh Sisodia 2, Rahul Mishra 3*
&
Devesh Pratap singh 1

Due to the excessive growth of PM 2.5 in aerosol, the cases of lung cancer are increasing rapidly and
are most severe among other types as the highest mortality rate. In most of the cases, lung cancer
is detected with least symptoms at its later stage. Hence, clinical records may play a vital role to
diagnose this disease at the correct stage for suitable medication to cure it. To detect lung cancer
an accurate prediction method is needed which is significantly reliable. In the digital clinical record
era with advancement in computing algorithms including machine learning techniques opens an
opportunity to ease the process. Various machine learning algorithms may be applied over realistic
clinical data but the predictive power is yet to be comprehended for accurate results. This paper
envisages to compare twelve potential machine learning algorithms over clinical data with eleven
symptoms of lung cancer along with two major habits of patients to predict a positive case accurately.
The result has been found based on classification and heat map correlation. K-Nearest Neighbor Model
and Bernoulli Naive Bayes Model are found most significant methods for early lung cancer prediction.

Keywords Lung cancer, Machine learning, Classification, Prediction, Confusion matrix, Heat map
correlation

The respiratory disease has enormously increased over the last decades which may be directly associated with
the exposer of humans to the polluted atmosphere. Sustainable development goals (SDGs) ensure an aspiration
of health and well-being for a­ ll1, target 3.9 is associated with reducing death and illness from air, water, and soil
­pollution2. Lung cancer is one of the most lethal diseases caused with increasing mortality rates globally by air
pollution. Usually, this type of cancer begins in the lungs and may spread to other section of the body and its
causes includes smoking, air pollution, and exposure to peculiar ­chemicals3. The prognosis for lung cancer var-
ies depending on the type, stage, and overall health of the individual. The initial phases of lung cancer may not
usually manifest symptoms. If early symptoms manifest, they may encompass symptoms such as short breath-
ing, in addition to unforeseen symptoms like back pain. Tumors can lead to back pain by exerting pressure on
the lungs or by spreading to the patient’s spinal cord and r­ ibs4. Additional initial symptoms of lung cancer may
encompass: a persistent or getting worse cough, expectorating phlegm or blood, exacerbation of chest pain during
deep breathing, laughter, or coughing, hoarseness, wheezing, weakness, and fatigue, reduced appetite and weight
loss, recurring respiratory infections like pneumonia or b ­ ronchitis5. The initial manifestations of lung cancer
may be subtle, however, an early diagnosis is crucial for effective treatment alternatives and potential results.
However, it is a great challenge to detect and diagnose it in the early stage by doctors and researchers. The
advancement in the storage of health records on digital platforms and data visualizations improved pattern
­analysis6. The early prediction of disease based on symptoms and textual information may enhance the diagnosis
system. Aside from medical methods, soft computing techniques like applying machine learning algorithms to
the main features of large, complicated lung cancer datasets may be significant for a specialist to find the disease
early. On the contrary, the precision of detection depends on the availability of data and the process of selecting
important measures, which further results in adequate treatment decisions.
Diverse mathematical models have already been utilized for the detection and prevention of diseases to
facilitate early treatment. However, if lung cancer is diagnosed three years after its onset, it becomes unprevent-
able, and the likelihood of survival is extremely ­poor7,8. Nevertheless, it is possible to treat the disease when the

1
Department of Computer Science and Engineering, Graphic Era (Deemed to be University), Dehradun,
India. 2Department of Computer Science and Engineering, Indus University, Ahmedabad 382115,
India. 3Department of Electronics and Computer Engineering, National Institute of Advanced Manufacturing
Technology (NIAMT), Ranchi, India. *email: [email protected]

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earliest signs are present before metastasis. Thus, if cancer is found within a specific time-frame of curability,
along with various risk factors for further diagnosis, a suitable therapy can be provided to the patient, enabling
the implementation of appropriate preventive measures. Several computer methods have been used to find or
predict lung cancer, which helps doctors figure out the best way to treat patients and their chances of survival
after being diagnosed. Researchers in the field of medical sciences have employed machine learning and soft
computing approaches to accurately diagnose several forms of cancer in their early stages using categorization
methods. Furthermore, researchers have identified various cutting-edge methods for early-stage prognosis of
cancer therapy ­outcomes9. However, it is crucial to determine an appropriate learning algorithm for the purpose
of detecting lung cancer and its correlation with the patient’s habits. This research aims to conduct a comparative
analysis of several machine learning algorithms on the characteristics related to lung cancer, specifically focusing
on the symptoms exhibited by patients and their habits.

Machine learning algorithms in lung cancer prediction

Lung cancer also referred to as lung carcinoma in the usual medical term, is originally a malignant tumor that
grows in lung cells uncontrollably and can be identified by cell proliferation. Recent advancements in computer
vision have enabled scientists to introduce various diagnostic methods using temporal image a­ nalysis10. How-
ever, with the growth in clinical data repositories, not only image analysis but also text data played a vital role in
diagnosis. Several lung cancer studies focus on detection using symptom data and treatment decisions based on
artificial intelligence, image processing, and learning algorithms. Several researchers implied neural network,
support vector machine and decision t­ ree10 convolutional neural network based non-linear cellular a­ utomata11
Random Forest, XGBoost, and Logistic ­Regression12 i.e. machine learning algorithms on clinical dataset to predict
the recurrence of lung cancer and its survivability. A few comparative studies have also been presented such as
ensemble techniques of Bagging and Adaboost and K-Nearest Neighbors, Decision Tree, and Neural Networks
on Surveillance, Epidemiology and End Results (SEER) ­dataset13, XGBoost, GridSearchCV, Logistic Regression,
Support Vector Machine, Gaussian Naïve Bayes, Decision tree, and K-Nearest Neighbor ­classifiers14 to evaluate
lung cancer prediction through precision, recall, F1-Score parameters generated using confusion matrix and
Area Under Curve (AUC) & Receiver Operating Characteristic (ROC) analysis. A few more machine learning
classifiers such as Logistic Regression, Naïve Bayes and Random Forest, Support Vector Machine (SVM), Arti-
ficial Neural Network (ANN), k-Nearest Neighbors (KNN), Radial Basis Function Network (RBF), J48, MLP,
Gradient Boosted Tree, Majority Voting, also tried for observing the performance of lung cancer ­prediction15,16.
Specifically, some standard machine learning techniques such as decision tree, boosting, random forest, neural
network, naïve bayes, KNN, SVM are frequent in lung cancer p ­ rediction17. These machine learning algorithms
showed their applicability on a temporal real-world larger dataset of lung cancer for risk ­prediction18,19.
In binary classification, while using various methods, especially in diagnostic, prognostic and predictive
research, Receiver Operating Characteristic (ROC) and Area under the Curve (AUC) analysis is an effective
technique usually utilized to calculate measurement for the assessment of the differentiating ability of ­methods20.
The ROC curve is used to assess a test’s overall diagnostic performance and compare the performance of two or
more diagnostic t­ ests21. In other words, the ROC is informative about the performance over a series of thresholds
and can be summarized by the AUC, which is a single n ­ umber22. Also, A gender and age based study for a lung
cancer dataset has been performed using machine learning which shows the potential of applicability of naïve
bayes, SVM, KNN, random forest, decision tree, AdaboostM1, and neural n ­ etwork23.
Apart from the above analysis, it is essential to inter-relate patient’s habits and symptoms, hence more precise
in diagnosing and treating lung cancer. Moreover, it is equally important to find a suitable method of analyz-
ing these datasets. Very few attempts have been made to compare different machine-learning methods for lung
cancer prediction.

Dataset preparation and analysis

Dataset for lung cancer prediction has been collected from the source The dataset consists of a total of 16 attrib-
utes with 310 instances. The dataset attributes in the given instances are distributed over gender i.e., male and
female. Table 1 illustrates the detailed description of all the 16 input feature attributes in the lung cancer study
dataset, which are used in the prediction of lung cancer. The attributes are divided into two categories Habits
and Symptoms, which may take values as positive or negative where represented by numeric 2 [yes] and 1 [no]
respectively Table 2. There were thirty-three duplicate entries among the given instances in this dataset, which
were removed before processing. The instance frequency count was performed, and positive case distribution
was analyzed gender-wise. Further, the frequency analysis gender-wise has been performed for patient’s habits
and the symptoms identified individually. A Pearson’s Correlation has also been plotted as a heat map to assess
the attribute’s importance among the others. The attributes of the clinical dataset have been chosen based on the
experts of this specialization and to measure the effectiveness of the cancer prediction system, which further
helps the patient to know their cancer risk with low cost and decisions based on their appropriate treatment.
Data are split into two sets of (80%) for training and testing (20%) of the dataset. During the training process,
each model underwent 10-fold cross validation. This involved splitting the training set into a training subset
and a validation subset with a ratio of 10:1 to fine-tune the attributes. The final accuracy metric was established
by using the outcomes from the ten cross-validated models and the Area Under Curve (AUC) the Receiver
Operating Curve (ROC).

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Attribute Description [values] Values

Gender Indicates gender of the patient M [Male], F [Female]
Age Age of patients Numeric value
Smoking Smoking habit of patient 2 [Yes], 1 [No]
Yellow_fingers Patient has symptom of yellow finger 2 [Yes], 1 [No]
Anxiety Patient having anxiety 2 [Yes], 1 [No]
Peer_pressure Patient undergoes peer pressure 2 [Yes], 1 [No]
Chronic disease Any chronic diseases identified 2 [Yes], 1 [No]
Fatigue Patient having fatigue 2 [Yes], 1 [No]
Allergy Patient facing any allergy 2 [Yes], 1 [No]
Wheezing Breathing with a husky or whistling sound 2 [Yes], 1 [No]
Alcohol consuming Patient is alcoholic 2 [Yes], 1 [No]
Coughing Patient having cough problem 2 [Yes], 1 [No]
Shortness of breath Patient facing shortness of breath 2 [Yes], 1 [No]
Swallowing difficulty Patient having difficulty in swallowing 2 [Yes], 1 [No]
Chest pain Patient having cough problem 2 [Yes], 1 [No]
Lung_cancer Lung cancer detected in patient Yes[Positive], No [Negative]

Table 1.  Description of all 16 input attributes in lung cancer study dataset.

Types Attributes Values and description

Smoking
Habits
Alcohol consuming
Yellow fingers
Anxiety
Peer pressure
Fatigue
Chronic diseases 1 [No], 2 [Yes]
Symptoms Allergy
Wheezing
Chest pain
Cough
Shortness of breath
Swallowing difficulty

Table 2.  List of patient’s habits and symptoms in lung cancer study dataset.

Figure 1.  Positive case distribution gender-wise.

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Results and discussion

Primarily, the data has been analyzed based on positive and negative cases among males and females over the
age distribution; Fig. 1 shows 52.52% of males and 47.48% of females are affected with the disease, while Fig. 2
shows most of the distribution identified within age 55 years and 75 years.
Thereafter, the next observation considered for distribution over positive and negative samples of patient’s
habits, i.e., Smoking and Alcohol consumption, in which 54.2% male and 45.80% females are found to have posi-
tive cases of smoking, whereas 69.65% males and 30.35% females are found positive for alcohol consumption.
Figure 3 illustrates the result for the positive and negative case distribution gender-wise over patient’s habits.
The third observation is based on the patient’s symptoms, i.e., yellow fingers, anxiety, chronic disease, chest
pain, fatigue, wheezing, coughing, short breathing, swallowing difficulty, and allergy. The comprehensive study
shows that 42.5% males and 57.5% females have yellow fingers, 41.6% males and 50.4% females have anxiety,
43.5% males and 56.5% females have a chronic disease, 66.2% males and 33.8% females having chest pain, 50.9%
male and 49.1% female having fatigue, 57% male and 43% female having wheezing, 57% male and 43 female
having coughing, 52.3% male and 47.7% female having short breath, 46.6% male and 52.4% female having swal-
lowing, 58.2% male and 41.8% female having allergy are found positive. Figure 4 illustrates the result for the
distribution of positive and negative cases gender-wise over patient’s symptoms.
This observation shows that Yellow Finger, Coughing, Chronic Disease, Chest Pain, and Allergy are critical
symptoms while studying data gender-wise. However, to know the significance of each attribute against another
attribute, we have comprehended Pearson’s correlation; since alcohol consumption showed a significant effect
(69.65%) on lung cancer detection, so we perform a correlation considering alcohol consumption. To analyze the
correlation, the thumb rule has been directly used as Pearson correlation coefficient (r) value if r > 0.5 Strong
Positive, 0.3 < r > 0.5 is Moderate Positive, and 0 < r > 0.3 Weak Positive. Lung cancer with alcohol-consuming
habits is moderately correlated; also, it is correlated with chest pain and allergy, as shown in the correlation heat
map in Fig. 5.

Figure 2.  Positive case distribution age-wise over gender in the given dataset.

Figure 3.  Positive and negative case distribution gender-wise over patient’s habits.

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Figure 4.  Distribution of positive and negative cases gender-wise over patient’s symptoms.

Figure 5.  Correlation heat map for attributes considering alcohol consuming as habit of patient.

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Now, we can apply different machine learning algorithms to understand the significance of the algorithm
in this problem domain. Based on the literature survey, we have identified a few learning algorithms for lung
cancer prediction viz. (1) Logistic regression, (2) Gaussian Naïve Bayes, (3) Bernoulli Naïve Bayes, (4) Support
vector machine, (5) Random forest, (6) K-Nearest neighbor, (7) Extreme Gradient boosting, (8) Extra tree,
(9) Ada boost, (10) Ensemble_1 with XGB and ADA, (11) Ensemble_2 with Voting Classifier, (12) Multilayer
Perceptron (MLP).

Comparison of performance of algorithms

We have applied different machine learning algorithms to the clinical dataset of lung cancer after preliminary
statistical analysis. Based on the correlation analysis of the attributes, the dataset has been squeezed for the
model for lung cancer prediction. However, to evaluate the performance of the learning algorithms confusion
matrix, ROC curve (receiver operating characteristic curve) and AUC (area under the ROC curve) have been
considered, whereas a detailed classification report has also been availed with each method. The models have
been analyzed in Jupyter v7.0.6 run environment with the support of Python v3.11; the confusion matrix, ROC/
AUC, and classification report consist of precision, recall, F1-score, and support, which are used to calculate the
accuracy of the model. The analysis has been arranged in three parts viz. (1) Confusion Matrix, (2) ROC/AUC,
and (3) Classification Report in which the confusion matrix is helpful to calculate precision and recall, and so the
F1-score, AUC ensures the reliability of the model, and the classification report gives the overall statistics of the
models. Figure 6 illustrates the confusion matrix for all the discussed machine learning models, which compares
all mentioned machine learning algorithms on the confusion matrix. Figure 7 illustrates the AUC graph for all
the discussed machine learning models, which compares all mentioned machine learning algorithms on the
confusion matrix. Also, the set of Tables 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 and 14 represent the classification report
for the accuracy of all the compared machine learning algorithms for lung cancer prediction.
The comparative study suggests that the accuracy of K-Nearest Neighbor is highest, i.e., 92.86%, and Ber-
noulli Naïve Bayes, Gaussian Naïve Bayes is 91.07% in Table 15. So, finally, we can conclude that the K-Nearest
Neighbor and Bernoulli Naïve Bayes models give better results on the smaller dataset with binary characteristics.
They are more suitable when attributes/features are highly independent in the given dataset. Since other models
are dependent on correlation and training/testing splitting of the dataset, they could not be performed better
for the dataset.

Figure 6.  A comparative study of learning algorithm through confusion matrix over lung cancer dataset.

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Figure 7.  A comparative study of learning algorithm through ROC/AUC over lung cancer dataset.

Precision Recall f1-score Support

0 1.00 0.42 0.59 12
1 0.86 1.00 0.93 44
Macro avg 0.93 0.71 0.76 56
Weighted avg 0.89 0.88 0.85 56
Accuracy 0.88 56

Table 3.  Classification report for LR classifiers. The accuracy of logistic regression is 87.5%.

Precision Recall f1-score Support

0 0.89 0.67 0.76 12
1 0.91 0.98 0.95 44
Macro avg 0.90 0.82 0.85 56
Weighted avg 0.91 0.91 0.91 56
Accuracy 0.91 56

Table 4.  Classification report for Gaussian Naive Bayes classifiers. The accuracy of Gaussian Naive Bayes is
91.07%.

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Precision Recall f1-score Support

0 0.89 0.67 0.76 12
1 0.91 0.98 0.95 44
Macro avg 0.90 0.82 0.85 56
Weighted avg 0.91 0.91 0.91 56
Accuracy 0.91 56

Table 5.  Classification report for Bernaulli Navie classifier. The accuracy of Bernoulli Naive Bayes is 91.07%.

Precision Recall f1-score Support

0 1.00 0.33 0.50 12
1 0.85 1.00 0.92 44
Macro avg 0.92 0.67 0.71 56
Weighted avg 0.88 0.86 0.83 56
Accuracy 0.86 56

Table 6.  Classification report for SVM classifier. The accuracy of Support Vector Machine is 85.71%.

Precision Recall f1-score support

0 1.00 0.33 0.50 12
1 0.85 1.00 0.92 44
Macro avg 0.92 0.67 0.71 56
Weighted avg 0.88 0.86 0.83 56
Accuracy 0.86 56

Table 7.  Classification report for Random Forest Classifiers. The accuracy of Random Forest Classifier is
85.71%.

Precision Recall f1-score Support

0 0.90 0.75 0.82 12
1 0.93 0.98 0.96 44
Macro avg 0.92 0.86 0.89 56
Weighted avg 0.93 0.93 0.93 56
Accuracy 0.93 56

Table 8.  Classification report for K Nearest Neighbors Classifier. The accuracy of K Nearest Neighbors
Classifier is 92.86%.

Precision Recall f1-score Support

0 1.00 0.50 0.67 12
1 0.88 1.00 0.94 44
Macro avg 0.94 0.75 0.80 56
Weighted avg 0.91 0.89 0.88 56
Accuracy 0.89 56

Table 9.  Classification report for Extreme Gradient Boosting Classifier. The accuracy of extreme gradient
boosting classifier is 89.29%.

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Precision Recall f1-score Support

0 1.00 0.50 0.67 12
1 0.88 1.00 0.94 44
Macro avg 0.94 0.75 0.80 56
Weighted avg 0.91 0.89 0.88 56
Accuracy 0.89 56

Table 10.  Classification report for Extra Tree Classifier. The accuracy of extra tree classifier is 89.29%.

Precision Recall f1-score Support

0 1.00 0.50 0.67 12
1 0.88 1.00 0.94 44
Macro avg 0.94 0.75 0.80 56
Weighted avg 0.91 0.89 0.88 56
Accuracy 0.89 56

Table 11.  Classification report for Ada Boost Classifier. The accuracy of ada boost classifier is 89.29%.

Precision Recall f1-score Support

0 1.00 0.50 0.67 12
1 0.88 1.00 0.94 44
Macro avg 0.94 0.75 0.80 56
Weighted avg 0.91 0.89 0.88 56
Accuracy 0.89 56

Table 12.  Classification report for Ensemble_1 with XGB and ADA Classifier. The accuracy of Ensemble_1
with XGB and ADA Classifier is 89.29%.

Precision Recall f1-score Support

0 1.00 0.42 0.59 12
1 0.86 1.00 0.93 44
Macro avg 0.93 0.71 0.76 56
Weighted avg 0.89 0.88 0.85 56
Accuracy 0.88 56

Table 13.  Classification report for Ensemble_2 with Voting Classifier. The accuracy of Ensemble_2 with
Voting Classifier is 87.5%.

Precision Recall f1-score Support

0 0.88 0.58 0.70 12
1 0.90 0.98 0.93 44
Macro avg 0.89 0.78 0.82 56
Weighted avg 0.89 0.89 0.88 56
Accuracy 0.89 56

Table 14.  Classification report for MLP Classifier. The accuracy of MLP Classifier is 89.29%.

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S. No. Model name Accuracy (%)

1 Logistic Regression 87.5
2 Gaussian Naive Bayes 91.07
3 Bernoulli Naive Bayes 91.07
4 Support Vector Machine 85.71
5 Random Forest 85.71
6 K-Nearest Neighbors 92.86
7 Extreme Gradient Boosting 89.29
8 Extra Tree 89.29
9 ADA Boost 89.29
10 Ensemble_1 with XGB and ADA 89.29
11 Ensemble_2 with Voting Classifier 87.5
12 MLP 89.29

Table 15.  A comparison of the accuracy of different learning algorithms applied over lung cancer.

Conclusion
Prediction of lung cancer can be useful if the system for cancer prediction works after symptom detection and
also correlates to the patient’s habits and state about the cancer at a low risk. Furthermore, the expert may advise
the suitable treatment option based on the individual’s cancer risk status. However, it is important to be precise
while predicting lung cancer in a patient. The raw data having 310 instances has been processed to find positive
cases gender-wise and then compared individual positive cases for each attribute gender-wise. A correlation
study over alcohol consumption habits has identified that yellow finger and allergy are the main symptoms
while conducting a preliminary analysis of the data. This study focused on the comprehensive analysis of twelve
potential different machine learning algorithms in which the K-nearest neighbor and Bernoulli Naïve Bayes
model (equally well as Gaussian Naïve Bayes) are found suitable with accuracy 92.86% and 91.07% respectively.

Limitations and future scope

This study reveals the potentials of various machine learning algorithms on textual clinical data for lung cancer
early detection. However, this study is performed on a small dataset, which depends on the patient’s habits and
symptoms. The study may be performed on a larger dataset to analyse the variability in the algorithm’s perfor-
mance. Moreover, a fine correlation may be established to improve the efficiency of the early-stage detection
method. Moreover, This study may also be performed on a larger authentic dataset which must contain at least
these 16 parameters, as the classification has been done based on symptoms and habits. Some potential algo-
rithms such as Ensemble 1 with XGB and ADA, Multilayer Perceptron (MLP) may be further analyzed for larger
dataset. Apart from statistical analysis, the study through data observation, it is likely find that males having the
habit of alcohol consumption having symptom of chest pain and allergy have a higher chance of detecting lung
cancer. However, we need an expert opinion for this insight, which may lead to establishing a weighting system
the specific attribute in lung cancer detection.
Electronic Health Record (EHR) dataset may play a vital role in early detection of lung cancer. Thus, the clini-
cal data may be utilized to draw the similarities among the parameters for the patient and the AUC achieved by
the applied model. Further, more studies need to verify this process of model adoption.

Data availability
The datasets generated and/or analysed during the current study are available in the Data source: https://​www.​
kaggle.​com/​datas​ets/​sanjo​li02/​lung-​cancer.

Received: 2 February 2024; Accepted: 27 March 2024

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Author contributions
Satya Prakash Maurya-Conceptualization, Methodology, Writing-original draft, Validation Pushpendra Singh
Sisodiya-Writing-review & editing, Visualization, Supervision, Investigation, Resources, Project Management.
Rahul Mishra-Writing-review & editing, Visualization, Supervision, Investigation, Project Management. Devesh
Pratap Singh-Methodology, Writing-review & editing, Validation, Resources.

Competing interests
The authors declare no competing interests.

Additional information
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