# Reasoning Language Model for Personalized Lung Cancer Screening

arXiv: https://arxiv.org/abs/2509.06169 · HTML: https://mlsanity.com/paper/2509.06169/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 6 of its 25 references that are in the map.
- First posted on arXiv 7 Sep 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 6 of 6)

- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [DAPO: An Open-Source LLM Reinforcement Learning System at Scale](https://mlsanity.com/paper/2503.14476/) (2025)
- [Chain of Thought Empowers Transformers to Solve Inherently Serial Problems](https://mlsanity.com/paper/2402.12875/) (2024)
- [Chain of Thought Monitorability: A New and Fragile Opportunity for AI Safety](https://mlsanity.com/paper/2507.11473/) (2025)

## Built on by (most cited first, 1 of 1)

- [Foundation Models for Medical Imaging: Status, Challenges, and Directions](https://mlsanity.com/paper/2602.15913/) (2026)

## Abstract (arXiv)

Accurate risk assessment in lung cancer screening is critical for enabling early cancer detection and minimizing unnecessary invasive procedures. The Lung CT Screening Reporting and Data System (Lung-RADS) has been widely used as the standard framework for patient management and follow-up. Nevertheless, Lung-RADS faces trade-offs between sensitivity and specificity, as it stratifies risk solely based on lung nodule characteristics without incorporating various risk factors. Here we propose a reasoning language model (RLM) to integrate radiology findings with longitudinal medical records for individualized lung cancer risk assessment. Through a systematic study including dataset construction and distillation, supervised fine-tuning, reinforcement learning, and comprehensive evaluation, our model makes significant improvements in risk prediction performance on datasets in the national lung screening trial. Notably, RLM can decompose the risk evaluation task into sub-components, analyze the contributions of diverse risk factors, and synthesize them into a final risk score computed using our data-driven system equation. Our approach improves both predictive accuracy and monitorability through the chain of thought reasoning process, thereby facilitating clinical translation into lung cancer screening.