Roll out AI-supported mammography nationally as a stepped-wedge trial
Sweden's MASAI trial showed AI can safely replace one of two radiologists. Rolling it out region by region in a randomised order would prove it works at national scale and that interval cancers do not rise.
MASAI (Lund) demonstrated a 44% workload reduction and higher cancer detection with AI-supported reading. Rather than piecemeal adoption, propose national programmes adopt in a randomised stepped-wedge order so every region serves as its own control, with interval cancer rate and recall rate as co-primary endpoints.
- Most lethal cancers are found late · Screening exists for only a few cancers. Pancreatic, ovarian, liver, oesophageal and most lung cancers are found when cure is unlikely.
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
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