The future of breast cancer screening: what do participants in a breast cancer screening program think about automation using artificial intelligence?

BACKGROUND: If screening participants do not trust computerized decision-making, screening participation may be affected by the introduction of such methods. PURPOSE: To survey breast cancer screening participants’ attitudes towards potential future uses of computerization. MATERIAL AND METHODS: A survey was constructed. Women in a breast cancer screening program were invited via the final report letter to participate. Data were collected from February 2018 to March 2019 and 2196 surveys were completed. Questions asked participants to rate propositions using Likert scales. Data analysis was done using χ(2) and logistic regression tests. RESULTS: The mean age of participants was 61 years. Response rate was 1.3%. Of the submitted surveys, 97.5% were complete; 38% of respondents reported a preference for a computer-only examination. The highest level of confidence was given a computer-only reading followed by a physician reading. Participants with > 12 years of education were more likely to prefer a computer-only reading (odds ratio [OR] 1.655, 95% confidence interval [CI] 1.168–2.344), had a greater trust in letting a computer determine screening intervals and the need for a supplemental MRI (OR 1.606, 95% CI 1.171–2.202 and OR 1.577, 95% CI 1.107–2.247, respectively). Age was not found to be a significant predictor. CONCLUSION: A high level of trust in computerized decision-making was expressed. Higher age was associated with a lower understanding of technology but did not affect attitudes to computerized decision-making. A lower level of education was associated with a lower trust in computerization. This may be valuable knowledge for future studies.