Artificial Intelligence in Disease Diagnostics:

Rethinking Risk Factors for Cervical Cancer

Naresh Kumar Trivedi Raj Gaurang Tiwari Vinay Gautam
Chitkara University Institute of Chitkara University Institute of Chitkara University Institute of
Engineering and Technology, Engineering and Technology, Engineering and Technology,
Chitkara University Chitkara University, Chitkara University,
Punjab, India Punjab, India Punjab, India
nareshk.trivedi@chitkara.edu.in rajgaurang@chitkara.edu.in vinay.gautam@chitkara.edu.in

Vikrant Sharma Anuj Kumar Jain

Department of Computer Science and Chitkara University Institute of
Engineering, Engineering and Technology,
Graphic Era Hill University, Chitkara University,
Dehradun, India Punjab, India
vsharma@gehu.ac.in anuj.jain@chitkara.edu.in

Abstract—As machine learning evolves, many individuals
and businesses utilize numerous algorithms to evaluate massive
data sets and create actionable insights that aid in predicting
behavior. And this type of technology is increasingly employed in
the medical industry to forecast the early stages of certain severe
diseases, such as cervical cancer. There has been a significant
amount of research conducted on cervical cancer in recent years.
Studies have focused on various topics such as risk factors for
cervical cancer, early detection and screening, and the
effectiveness of different treatment options. In this study, we
conduct an in-depth comparison of the various machine learning
methods, discussing their relative merits and shortcomings in
terms of accuracy and overall performance. Staking which is an
ensemble machine learning approach emerges as the best
approach for Cervical cancer classification.
Keywords— Classification, Cervical cancer, machine
learning, Neural Network, Stacking
I. INTRODUCTION
One of the illnesses that are becoming more of a problem
for women is cervical cancer. Among women, the rate of
malignant tumors is greatest in developing countries and third
highest in industrialized countries. Nearly a third (28.8
percent) of the world's cervical cancer cases are found in
China each year, where 140,000 new cases are identified
annually. In China, it is the most common malignancy of the
female reproductive system [1]. When it first begins showing
itself, it might be difficult to identify. Cervical cancer cannot
be detected in any other way than via routine screenings.
Magnetic resonance[2] and diffusion-weighted imaging[3] are
ineffective in detecting the disease in its early stages. The
Human Papillomavirus (HPV), having your first sexual
encounter at a young age, smoking, and so on are all factors
that increase your chance of developing cervical cancer. The
human papillomavirus (HPV) is the single greatest cause of
cervical cancer[4]. Researchers have shown that in
comparison to nonsmokers, those who are infected with HPV
and also smoke have a threefold increased risk of developing
cervical cancer [5]. These days, early illness detection makes
use of a wide range of detection methods, some of which are
based on machine learning.
Vapnik [6] developed SVM, now one of the most used
classification methods, based on the idea of using a partition
hyperplane to split a sample space into subspaces
corresponding to different classes. For its intended purposes,
it has been successfully applied in a wide variety of fields,
including image recognition, text classification, data
forecasting, etc. [7].
Decision trees are widely used in many fields for data
classification, including business, healthcare, and education.
Samples are primarily categorized according to a division of
characteristics, which is its defining feature. Many decision
tree-based ensemble methods, such as Random Forests and
XGBoost, employ decision trees as their core classifier,
reaping the benefits of both their superior accuracy and
generalizability. XGBoost is a powerful and efficient
approach for designing classifiers.
When it comes to labeling large datasets with many
attributes, the Random Forest method is the gold standard. It
employs a tree-structured method of analysis for making
categorizations and predicting outcomes. This research
compares the risk features of the dataset from the UCI
repository [8] using three machine learning-based approaches
(XGBoost, SVM, and Random Forest).
Five distinct parts make up the framework of this study.
Methodologies employed in data analysis are outlined in
Section III. In the IV section, we assess the features and
quality of the cervical cancer dataset. The results and effective
strategies are also discussed in this section. In this final
portion, the study reaches the conclusion.
II. RELATED WORKS
Studies have been conducted to determine what variables,
such as human papillomavirus (HPV) infection, smoking, and
a compromised immune system, increase a person's chance of
developing cervical cancer. The early identification and
screening of cervical cancer, using tools like the Pap test and
HPV testing, is another field of study [9], [10].
Surgery, radiation therapy, and chemotherapy are only
some of the treatment options for cervical cancer, and their
efficacy has been the subject of many studies. Research on
immunotherapy and targeted therapy for the treatment of
cervical cancer has also been performed.
In addition, there has been an increasing focus on the
development of new technologies, such as liquid-based
cytology, to improve cervical cancer screening and to develop
new biomarkers to detect cervical cancer early [11][12].
A classifier for cervical cancer was coupled with the
revised segmentation using machine learning methods;
random forests were shown to be the most effective [14]. To
handle the plethora of images that are produced by the
recovered objects, unsupervised learning, and robust
refinement approaches are used, such as Adaboost detectors
[15], SVM supports [16], and Gaussian mixture models [17].
It was developed and implemented a new method of cell
segmentation based on the Markov random field that makes
use of superpixels to distinguish between cells that do not
overlap. To identify cervical cells, the authors use the
multifilter SVM using the settings described in [19]. Artificial
neural networks (ANN) were developed and evaluated and
found to classify cervical cells with 78 percent accuracy[20].
An unsupervised method [21] was used to evaluate the quality
of the medical evidence for each subtype of cervical cancer.
When compared to other simple classification models, PSO
with KNN membership values fared better [22]. Cervical
cancer cells are segmented and classified using a Gabor-based
technique based on their form and texture. The percentage of
correctly identified cancerous cells rose to 89 percent [23].
One of the recommended model's reference components, the
least-square support vector machine (LSSVM), was used to
categorize the CNN features, with even better results.
Comparatively, RBF-based support vector machines (SVMs)
outperformed logistic regression and random forest methods
[25]. Accuracy based on features was predicted to be between
90% and 95%.
Overall, research on cervical cancer is ongoing and
continues to focus on improving early detection, developing
new treatment options, and increasing understanding of the
disease.
Fig. 1. Proposed Model Diagram
III. MATERIAL AND METHOD
A. Dataset
Cervical-cancer dataset[13] has been used in this study
B. Model Diagram
The proposed method is shown in a model diagram (fig.1)
below. The picture illustrates how the research for the model
developed.
C. Brief Description of Algorithms Used
1) k-Nearest Neighbors (k-NN): In the realm of machine
learning, it is a well-liked approach for solving classification
and regression issues. In order to make predictions, the k-NN
algorithm looks for the k-nearest training instances in the
feature space. The k-NN algorithm uses a distance metric,
such as Euclidean distance, to measure the similarity between
the input data and the training examples. Since no
assumptions about the data distribution are made by the k-
NN technique, it falls under the category of non-parametric
algorithms. It is simple to implement and does not require a
lot of computational resources, making it a popular choice for
many applications.
2) Neural networks: Machine learning algorithms based
on the human brain's structure and function are known as
neural networks. Known as artificial neurons, its structure
consists of stacked clusters of nodes that work together to
analyze and send data. Before reaching the output layer, the
input is altered and processed by numerous layers of these
artificial neurons. The weights of the connections connecting
the neurons are adjusted during training to bring the gap
between the expected and actual output closer together.
Neural networks are used extensively in many disciplines for
things like voice recognition, language processing, and
picture recognition. They are considered powerful
algorithms, as they can learn to model highly non-linear and
complex relationships between inputs and outputs[26].
 3) Stochastic Gradient Descent (SGD): It is an
optimization algorithm used for training machine learning
models, particularly for linear models such as linear
regression and neural networks. The algorithm starts with a
random set of weights and iteratively updates the weights by
adjusting them in the direction of the negative gradient of the
loss function. In each iteration, the algorithm uses a small set
of training examples, called a batch or mini-batch, to
calculate the gradient, instead of using the whole dataset. This
makes the algorithm computationally efficient and able to
handle large datasets. The algorithm is sensitive to the
learning rate, which controls the step size of the update, and
the choice of a suitable learning rate is critical for the
performance of the algorithm. SGD is a widely used
optimization algorithm as it is simple to implement and can
be used to train large datasets on distributed computing
architectures.
4) Stacking: Combining numerous models into one is
called "stacking," and it's a common machine-learning
strategy for boosting model accuracy. With stacking, you
take the predictions from many base models and feed them
into a single meta-model as features. The final prediction is
made by the meta-model using the characteristics given by
the basic models as input.
There are two main types of stacking: homogeneous and
heterogeneous. In homogeneous stacking, all the base models
are of the same type, while in heterogeneous stacking, the base
models are of different types. Stacking's primary value is that
it may boost model performance by using the best features of
many models while mitigating the worst. Additionally,
stacking might enhance the model's interpretability by
revealing which base models are most influential in producing
the final forecast inside the meta-model. The performance of
machine learning models in a wide range of applications,
including image classification, natural language processing,
and time series forecasting, may be improved using stacking,
a strong ensemble approach.
D. K-fold cross-validation
It is a common way to gauge a model's efficacy in the field
of machine learning. The procedure entails partitioning the
data into k "folds" of equal size, with k-1 of the folds serving
as training data and the remaining fold serving as test data.
After collecting data from the k-test sets, the model's efficacy
is determined by averaging the performance measure.
Since all the data is used for both training and testing, k-
fold cross-validation yields a more accurate estimate of the
model's performance. It may be useful for avoiding
overfitting, which happens when a model is perfected on its
training data but fails miserably when presented with novel
data.
The size of the dataset is the primary factor in deciding
what value of k to use. The model's performance can be
estimated more accurately with a bigger k number, but this
will need more time to train the model than with a lower k
value. In machine learning, k-fold cross-validation is used for
model comparisons, model evaluations, and hyperparameter
optimization. You may apply this technique in both
supervised and unsupervised, linear and non-linear models to
gain a more precise idea of how well they'll perform [11].
E. Performance evaluation metrics
Predictions made by a machine learning model may be
evaluated using these. The challenge at hand and the data at
hand should guide your selection of a performance measure.
There are a variety of indicators used to assess employee
performance.
• Precision refers to how well the model fits the data used
to make a forecast.
• Accuracy is the fraction of times a model correctly
predicts a value out of a set of values. This is the fraction
of cases when the model correctly predicted a good
outcome (Sensitivity).
• F1-Score strikes a fine chord between accuracy and
memorability.
• The area under the receiver operating characteristic curve
(ROC-AUC) is a metric for evaluating a binary classifier's
ability to separate positive and negative data.
IV. RESULT AND DISCUSSION
This article investigates three different approaches to
machine learning and makes use of ensemble learning in order
to make a prediction about cervical cancer. The five
characteristics that were used are outlined in the study's
methodology and materials. A total of 1015 samples were
collected after absenteeism and incidence statistics were
examined independently. With 20-K fold cross-validation, 20
different data sets were employed for testing and training.
Following are the 5 factors that conclude cervical cancer.
Dyskeratotic refers to cells or tissue that have abnormal,
irregular, or degenerative keratinization. In other words, it is a
term used to describe cells that have abnormal changes in the
process of forming the protein keratin, which is a key
component of the outer layer of skin and other structures in
the body. Dyskeratotic changes can be seen in a variety of
diseases and conditions and can be an indication of cell
dysfunction or dysfunction of the tissue.
Koilocytotic refers to cells that have a characteristic
appearance known as "koilocytes" when viewed under a
microscope. Koilocytes are cervical cells that have a
characteristic "halo" appearance, which is caused by changes
in the cell's cytoplasm and nucleus. They are often seen in
cervical infections caused by certain types of human
papillomavirus (HPV) and are considered a sign of cervical
dysplasia, which is a precancerous condition. Koilocytosis can
also be caused by other factors such as irritation or trauma.
Metaplastic refers to a type of cell or tissue transformation
in which one cell type is replaced by another. This process is
also known as transdifferentiation. For example, metaplasia is
the transformation of one type of epithelial cell into another
type, such as squamous cells becoming glandular cells.
Metaplasia occurs as a response to certain types of injury or
chronic irritation and can be seen in different organs and Predicted
tissues. In some cases, metaplasia can be a precursor to
malignancy, but not always. It is important to note that D K M P S ∑
metaplasia is a physiological process that can occur under D 242 7 1 1 0 251
normal circumstances as well as pathological conditions.

Actual
K 15 183 15 5 7 225
Parabasal cells are a type of cells that are found in the M 0 7 159 3 0 169
epithelium, which is the lining of certain organs and tissues in
P 0 0 0 163 0 163
the body. These cells are located at the basal layer of the
epithelium, which is the layer closest to the underlying tissue. S 0 0 0 0 207 207
They are typically larger and more irregular in shape than the ∑ 257 197 175 172 214 1015
more mature cells that are found in the upper layers of the
epithelium. Parabasal cells can be seen in a variety of
conditions, such as cervical dysplasia (precancerous changes Fig. 4. stochastic gradient descent
in the cervix) and vaginal atrophy (thinning of the vaginal
walls). They may also be seen in biopsy specimens taken from
the cervix or vagina because of infection, inflammation, or
other types of injury. High numbers of parabasal cells may Predicted
indicate a need for further evaluation or treatment. D K M P S ∑
A superficial-intermediate cell is a type of cell found in the
epidermis, the outermost layer of the skin. Superficial cells are D 243 7 1 0 0 251

Actual
in the uppermost layer of the epidermis and are responsible for
forming the protective barrier of the skin. Intermediate cells K 14 197 9 1 4 225
are in the middle layers of the epidermis and play a role in the M 0 6 162 1 0 169
formation of new skin cells. Both superficial and intermediate
cells are constantly shed and replaced by new cells produced P 0 0 0 163 0 163
in the lower layers of the epidermis [13]. S 0 0 0 0 207 207
Fig. 2-5 display confusion matrices for the k-nearest- ∑ 257 210 172 165 211 1015
neighbor (kNN), neural network, stochastic gradient descent, Fig. 5. Stack
and stacking models respectively. Here, Dyskeratotic,
Koilocytotic, Metaplastic, Parabasal, and Superficial-
Intermediate target classes have been abbreviated as D, K, M,
P and S respectively. It is evident from Table 1's confusion matrices and fig. 6
that kNN and SGD perform the worst in trials (TN). The
Predicted stacking model outperformed all other machine learning
D K M P S ∑ techniques with a maximum classification accuracy of 95.7%.
D 242 2 1 4 2 251
Actual

K 36 156 20 7 6 225
TABLE I. COMPARISON OF DIFFERENT MACHINE LEARNING
M 1 6 157 5 0 169 ALGORITHMS

P 0 0 0 163 0 163
Model AUC CA F1 Precision Recall
S 2 0 0 0 205 207
∑ 281 164 178 179 213 1015 kNN 0.988 0.909 0.905 0.913 0.909

Fig. 2. k-nearest-neighbor Stack 0.994 0.957 0.957 0.957 0.957

SGD 0.962 0.939 0.938 0.939 0.939
Predicted
Neural Network 0.996 0.952 0.951 0.952 0.952
D K M P S ∑
D 244 6 1 0 0 251
Actual

K 18 192 11 0 4 225
M 0 6 162 1 0 169
P 1 0 0 161 1 163
S 0 0 0 0 207 207
∑ 263 204 174 162 212 1015
Fig. 3. neural network
 1
V. CONCLUSION
0.98
Lifesaving and treatment decisions depend on an accurate
0.96 cervical cancer diagnosis. This research shows that cervical
cancer may be detected using machine learning methods. By
0.94 the use of ensemble learning with 20-fold cross-validation,
our neural network and SGD algorithms are able to achieve
score

0.92 an accuracy of 95.7% with the stacking model, and our other
classifiers also achieve a respectable degree of accuracy. This
0.9
research used a classification approach to identify risk factors
0.88 for cervical cancer. It is our goal to improve classification
accuracy by extracting more features/characteristics from the
0.86 present dataset in the future. For the greatest results, we will
also employ a wider array of Machine learning algorithms
0.84 and deep learning approaches, including transfer and deep
kNN Stack SGD Neural learning.
Network
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