Table 3:
Performance of Sybil, an Open-Source Deep Learning Model, for Predicting Lung Cancer from Low-Dose Chest CT Scans Stratified by Lung Cancer Visibility on Baseline CT Scans and Smoking Status
| Visibility of Lung Cancers at Baseline CT and Group | AUC* |
|---|---|
| Visible lung cancers | |
| Entire study sample (n = 17 969) | 0.91 (0.82, 1.00) |
| Individuals with available pack-year information (n = 12 728) | 0.89 (0.77, 1.00) |
| Heavy smoking (n = 2836) | 0.94 (0.93, 0.95) |
| Never- or light-smoking (n = 9892) | 0.89 (0.76, 1.00) |
| Future lung cancers | |
| Entire study sample (n = 17 917) | 0.67 (0.59, 0.75) |
| Individuals with available pack-year information (n = 12 668) | 0.65 (0.55, 0.74) |
| Heavy smoking (n = 2797) | 0.70 (0.58, 0.82) |
| Never- or light-smoking (n = 9871) | 0.56 (0.43, 0.70) |
Note.—Data in parentheses are 95% CIs. Sybil demonstrated robust predictive performance for visible lung cancers and good predictive performance for future lung cancers on baseline low-dose CT scans in the heavy-smoking subgroup. However, in the never- or light-smoking subgroup, its predictive performance was limited to visible cancers, with reduced discrimination for future cancers. Individuals with heavy smoking history were defined as those with at least 20 pack-years of smoking, including those who currently smoke and those who had quit within the past 15 years. All other individuals who ever smoked but did not meet these criteria were classified as having light smoking history (median, 2 pack-years in this study). Individuals with a never-smoking history were defined as those who had never smoked. For evaluation of visible lung cancer, future lung cancers on baseline CT scans were excluded. For evaluation of future lung cancer, visible lung cancers on baseline CT scans were excluded. The Sybil lung risk score is a deep learning–based risk score for predicting future lung risk within 6 years from a low-dose chest CT scan. AUC = time-dependent area under the receiver operating characteristic curve.
One-year AUC for visible lung cancers and 6-year AUC for future lung cancers on baseline CT scans.