Chatbots and Cancer Awareness

Effective public engagement is essential for cancer prevention and early detection. In-person engagement is often seen as the gold standard, but is intensive and not always possible or in fact needed.

Traditionally, when informed professionals aren’t available to advise members of the public, their alternative sources are in the form of static text information (leaflets, websites) which may be overly complex, or too nonspecific to answer the questions they may have.

To bridge this gap, interactive chat bots have emerged in recent years as an easy-to-use tool to engage with cancer patients, for example to provide assistance for patients on chemotherapy.

Now, when deployed as part of a multi-channel exercise, evidence is growing for the use of chatbots in engaging patients at risk of cancer: signposting cancer symptoms, reducing risk behaviours, and encouraging screening attendance:

·??????In the UK, the addition of a chatbot to a smoking cessation app led to significant increases in engagement, and patients with access to the chatbot had more than double the chance of successfully quitting;

·??????In France, a chatbot-based decision aid for participation in cervical cancer screening is being trialled, with the aim of increasing the number of women performing self-sampling at home, targeted at more deprived populations;

·??????A chatbot-based tool which takes a family history, to advise on your risk of hereditary cancer has been developed and is being tested in the US;

·??????Also in the US, a similar tool for patients due for routine appointments has been tested in over 61,000 participants, and informed over 14,000 patients of their eligibility for genetic testing.

Chatbots can also be accessed 24/7, and integrated with more visible digital platforms, such as Messenger or Whatsapp, for example with a project aiming to increase engagement with breast screening in England.

An example of national-scale use of a cancer information chatbot is the Angie service, introduced over WhatsApp in Singapore in 2021. ?Targeted at women suspected of having a risk of hereditary breast and ovarian cancer, Angie gives information on the syndrome, and how genetic testing can help. It can also take a family history, a process which can otherwise take an hour with a clinician, and leave patients overwhelmed by the information, and unable to make a decision to give consent for testing.

Reflections for Wales

Evidence such as the COVID Awareness and Beliefs Study (CABS) indicates that Wales currently faces a significant challenge in engaging people at risk of cancer to participate in screening, and present to healthcare when appropriate.

Wales has some experience in implementing chatbots. The RiTTA programme, a collaboration between Cardiff University, Velindre Trust, and Life Sciences Hub, has created an oncology assistant chatbot for cancer patients.

UK cancer charities also have experience developing these apps, for example with Bowel Cancer UK’s website chatbot, and the Cancer Research UK WhatsApp chatbot.

Wales also has a wealth of expertise and resource to develop and support the use of?these tools, through organizations such as TEC Cymru, and DHEW.

Chatbots are not of course the sole answer to the problem of public/patient engagement facing NHS Wales, but with the potential for 24/7 access to information and responsive public health messaging, could they be part of the mix?