Artificial Intelligence in Screening Mammography: A Population Survey of Women's Preferences

To investigate the general population's view on the use of artificial intelligence (AI) for the diagnostic interpretation of screening mammograms.

Dutch women aged 16 to 75 years were surveyed using the Longitudinal Internet Studies for the Social sciences panel, representative for the Dutch population. Attitude toward AI in mammography screening was measured by means of five items: necessity of a human check; AI as a selector for second reading; AI as a second reader; developer is responsible for error; and radiologist is responsible for error.

Of the 922 participants included, 77.8% agreed with the necessity of a human check, whereas the item AI as a selector for a second reading was more heterogeneously answered, with 41.7% disagreement, 31.5% agreement, and 26.9% responding with "neither agree nor disagree." The item AI as a second reader was mostly responded with "neither agree nor disagree" (37.1%) and "agree" (37.6%), whereas the two last items on developer's and radiologist' responsibilities were mostly answered with "neither agree nor disagree" (44.6% and 39.2%, respectively).

Despite recent breakthroughs in the diagnostic performance of AI algorithms for the interpretation of screening mammograms, the general population currently does not support a fully independent use of such systems without involving a radiologist. The combination of a radiologist as a first reader and an AI system as a second reader in a breast cancer screening program finds most support at present. Accountability in case of AI-related diagnostic errors in screening mammography is still an unresolved conundrum.