Evaluation of Cancer Survivors' Experience of Using AI-Based Conversational Tools: Qualitative Study

Cancer survivorship is a complicated, chronic, and long-lasting experience, causing uncertainty and a wide range of physical and emotional health concerns. Due to the complexity of cancer, patients often seek out multiple sources of health information to better understand the aspects of their cancer diagnosis. The high variability among patients with cancer presents significant challenges in treatment, prognosis, and overall disease management. Artificial intelligence (AI) chatbots can further personalize cancer care delivery. However, there is a knowledge gap regarding cancer survivors' perceived facilitators and barriers to adopting and using AI chatbots.

In this study, we examined cancer survivors' experiences of using existing AI chatbots and identified their facilitators and barriers to the adoption of AI chatbots.

We conducted a qualitative study to investigate the perceptions of cancer survivors, conducting semistructured interviews to understand their prior use of existing AI chatbots in general. We asked the participants about their perceptions regarding AI chatbot acceptability and comfort level; trust and adherence; and concerns, barriers, and suggestions. We used the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for this qualitative report.

Of 21 participants, 17 (81%) were female patients with breast cancer, 15 (71%) were aged 50 to 64 years, 19 (90%) were White, and 9 (43%) had a graduate degree. Participants' responses were grouped into three overarching themes: (1) patients' perceptions of interacting with chatbots compared to health care professionals, (2) patient-chatbot interaction, and (3) chatbot information processing. All participants who were interviewed reported that they would prefer interacting with health care professionals over a chatbot. The lack of empathy shown by chatbots was a major concern among cancer survivors. Many patients criticized chatbots for tending to provide a general overarching response to their questions rather than being specific to their cancer diagnosis. The main concerns of cancer survivors with using chatbots were the overabundance of general information that was often not relevant to their diagnosis and privacy of patient information.

The findings of this study underscore the critical importance of empathetic responses during AI chatbot interactions for cancer survivors, as the lack of personalized and emotional responses can lead to distrust and frustration. Clinically, these tools should be integrated as supplementary resources to enhance patient engagement while preserving essential human support. Policymakers need to develop guidelines that promote responsible use of AI in cancer care, prioritizing patient confidentiality and trustworthiness. AI chatbots have the potential to significantly improve the support provided to cancer survivors, but it is crucial to address the identified barriers and enhance user acceptance.