Patients Prefer AI in Skin Cancer Screening as an Assistive Tool, Not a Replacement

As artificial intelligence (AI) continues to integrate into dermatology, it’s important to not only ask how doctors are using it, but also how patients perceive it.

One popular way AI is being used in dermatology is through skin cancer screening. While many patients see AI as a valuable tool for improving accuracy and efficiency, they also prefer it to serve as an assistive tool rather than replace dermatologists, according to recent findings published in the Journal of Investigative Dermatology.¹

Patients expressed concern that doctors could become overreliant on AI. | Image credit: Seventyfour – stock.adobe.com

The review examined 16 studies on patient attitudes toward AI in skin cancer diagnosis, showing that while they acknowledge AI’s ability to analyze vast amounts of data quickly and accurately, they still have concerns about how their data are being protected and if clinicians will become overreliant on the tool. Importantly, these studies were published between 2012 and 2024 and mostly conducted in Europe, and with so many recent advancements in the AI health care space, further research is warranted.

“Although patients may not be directly interacting with AI, the implementation is more likely to impact them than stakeholders such as healthcare providers; administrators; AI experts; information technology staff; or compliance, legal, and ethical representatives,” the review authors wrote. “In addition, patient-centered care requires that patients be treated as equal partners in their overall care process and their needs and preferences be respected. Therefore, it is essential that patient perspectives are captured and that measures are taken to mitigate their concerns.”

Patients Want Transparency

With more than 9000 total patients surveyed, some of the biggest concerns boiled down to a singular theme seen across AI applications: transparency.

Interestingly, women had more reservations and concerns around AI than men. In comparison, women raised more questions about how their data and privacy would be handled and showed more concern around the lack of transparency with how AI makes and informs clinical decisions.

According to the review authors, these combined factors of data, privacy, and transparency influenced women to be less accepting of the tool in this setting, with half of the included studies reporting a correlation between a patient’s sex and how they will perceive and accept the use of AI in diagnosing skin cancer.

“This finding is consistent with previous research, which reported men to be more favorable of AI than women,” the authors noted.

They also found that patients with a history of skin cancer or melanoma tended to be more accepting of AI use in skin cancer screening than those without. While some individual studies demonstrated that age, education, and AI awareness could have an influence on AI acceptance, these correlations varied a lot and were not assessed in every study. For example, some research showed that younger patients trusted AI more, but this was challenged by other findings that older patients trust it more; some surveys showed a positive correlation between higher education and AI acceptance, while others showed an inverse correlation.

Patients also showed concern that overreliance on AI could impact their relationship with their care provider. While some believed AI could reduce the cognitive burden on clinicians and increase diagnostic efficiency, other patients worried it might lead to overreliance on technology and were hesitant to accept AI as a standalone diagnostic tool. In 5 studies, patients said they had a stronger preference and highest confidence in a dermatologist’s diagnosis, and were more likely to listen to it than a diagnosis made solely by AI.

Rather than favoring AI as a decision-maker, most patients preferred an augmented intelligence model, where AI works alongside dermatologists to enhance their decision-making. This approach aligns with trends seen in other medical fields, where AI assists in complex diagnoses but does not override human expertise.

In fact, many providers feel the same way. In an interview with The American Journal of Managed Care^® (AJMC^®), Douglas Flora, MD, FACCC, executive medical director of oncology services at St Elizabeth Healthcare, and editor in chief of AI in Precision Oncology, talked about how he also wants to use AI as an assistant rather than a replacement.² According to Flora, AI can help clinicians stay updated on current medical literature, help keep track of patient information, and help make better decisions.

“As we lean forward into this, maybe a year or 2 from now, the arrival of agentic AI and the agents that will assist us in our daily lives—both personal and professional—are exciting to me,” Flora told AJMC.³ “I think that's when the doctors will have sort of a J.A.R.V.I.S. on their shoulder that can help guide them and say, ‘This is the current evidence, this is current standard of care. Maybe this drug doesn't mix with that drug well. Would you like to be made aware of that?’ I would like to.”

He also echoed the sentiment that patient data need to be protected.

“We've proceeded very cautiously around patient health information; we really want to make sure that's kept sacrosanct,” he told AJMC.² “It's our responsibility to our patients not to share their things, so a lot of the early discussions were governance, cybersecurity, make sure that PHI [protected health information] is protected.”

References

1. Kuppanda PM, Janda M, Soyer HP, Caffery LJ. What are patients' perceptions and attitudes regarding the use of artificial intelligence in skin cancer screening and diagnosis? narrative review. J Invest Dermatol. Published online February 27, 2025. doi:10.1016/j.jid.2025.01.013
2. Klein HE, Flora D. AI is not going “back in Pandora’s box” in cancer care. AJMC. March 8, 2025. Accessed March 14, 2025. https://www.ajmc.com/view/ai-is-not-going-back-in-pandora-s-box-in-cancer-care
3. Klein HE, Flora D. Using AI to screen for cancers now may boost survival down the road. AJMC. March 12, 2025. Accessed March 14, 2025. https://www.ajmc.com/view/using-ai-to-screen-for-cancers-now-may-boost-survival-down-the-road