AI being examined for use in State’s breast cancer screening amid missed targets

The use of artificial intelligence (AI) is being examined in the State’s breast cancer screening service as increased demand and a shortage of radiographers has led to the programme missing targets.

The Health Service Executive (HSE) said it was “exploring” using AI in BreastCheck, Ireland’s free national breast screening programme for women and anyone aged between 50 and 69 with breasts or female breast tissue.

This includes some transgender, non-binary and intersex people, according to the HSE.

A record number of people were screened last year, but the programme missed its target for the third consecutive year due to increasing demand on the service.

The HSE posted a market consultation on the eTender website, consulting with AI companies to discuss potential use of this technology in BreastCheck.

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“All modern breast screening programmes face increasing operational pressures including rising patient volumes, radiologist workforce shortages, and growing demands for faster turnaround times while maintaining diagnostic accuracy,” the eTender notice says.

“The complexity of mammographic interpretation, combined with the need for consistent performance across large screening populations, creates challenges in delivering timely, high-quality care.

“Reader fatigue and workload pressures can impact diagnostic consistency, particularly during extended screening sessions.”

The noted added that additionally, there is “mounting pressure to improve early detection rates while minimising false positives and unnecessary recalls”.

“To address these challenges and enhance our screening programme’s effectiveness, we are exploring AI solutions that can augment radiologist capabilities, improve workflow efficiency, and maintain consistent diagnostic performance across our national screening network,” the notice said.

“As part of our due diligence process for implementing AI technology in BreastCheck, the NSS (National Screening Service) are conducting a comprehensive premarket consultation with potential AI solution providers.

“This consultation aims to evaluate available technologies against our specific clinical, technical, and regulatory requirements before making procurement decisions.”

Speaking at a conference organised by the Royal College of Physicians in Ireland (RCPI) on Thursday, Damian McCallion, chief technology officer at the HSE, said Ireland was a laggard in the European context on digital health.

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However, he said significant work is under way to increase digitisation, adding that he believes the use of AI in screening services is a particular opportunity.

McCallion referred to the lack of public trust in the CervicalCheck programme, following the 2018 revelations that hundreds of women were not informed that their previous cervical smear test results had been audited and changed

“The key thing there is patient confidence. It will not be perfect. But it will improve accuracy. If we bring patients along with that, that will make a huge difference. That will bring confidence in play,” he said.

The HSE has said BreastCheck will be the first programme to explore the use of AI because it has “the most mature evidence base for immediate implementation”.

International research from Sweden found AI-supported breast screening detected 20 per cent more breast cancers while potentially halving radiologist workload.