Enhancing the Breast Cancer Screening Journey: Exploring Women's Perceptions of Traditional Mammography and Emerging AI driven Thermography (Preprint)

BACKGROUND Breast cancer is one of the most frequent causes of mortality among women’s population. Early diagnosis is critical for successful treatment, but underscreening is frequent. Novel screening methods that are more convenient, such as thermography, are being developed. They could help a wider group of screeners and they could contribute to better compliance with screening and thus to a decline in breast cancer mortality. OBJECTIVE The study aims to explore the screeners’ preferences for the screening process, specifically for a novel screening that utilizes artificial intelligence (AI) and thermal imaging. Furthermore, we explore a better understanding of the barriers and facilitators associated with participation in breast cancer screening by currently used mammography. METHODS One online focus group with experts and five focus groups with potential screeners on thermography were carried out. Potential screeners were recruited through an online survey (n=228) focused on addressing barriers and motivations related to screening. Survey data were analyzed using SPSS software. Findings from the focus groups were examined by two researchers utilizing open, axial, and selective coding in MAXQDA software. RESULTS The information obtained in the focus groups showed that small changes during the procedure (tailored adjustments, such as film or music during the procedure, dimmed light) were appreciated, especially by women without any mammography screening experience. Furthermore, the non-invasiveness of the procedure was seen positively by all participants. Among other important factors that influence the perception of the procedure and can therefore affect the decision whether to go or not, was the way they were treated by medical staff and waiting hours. For certain women, how the interaction goes between them, and the clinicians is more important than the technology itself. Results from the online survey complemented these insights on motivation and barriers. Personal belief in breast cancer prevention was the most indicated motivator for women with mammography experience (44%, n=154), followed by an invitation from a screening program (29%, n=154). Barriers indicated by women without experience were mainly: no recommendation from a doctor (53%, n=74), no warning signals (36%, n=74) or no problem related to breasts (28%, n=74) followed by being too young for mammography (23%, n=74). CONCLUSIONS Even though the thermography was perceived mainly positively, rather than the technique itself, women prioritized how they were treated by medical staff. This includes detailed information in understandable language, empathetic communication and adjustments that fit personal preferences. As we also saw in the results from the survey, doctors play the leading role in the decision to go to the screening, so their change in the approach can encourage greater participation in breast cancer screening initiatives.