Evidence map›Paper›PMID 41807818›Full record

ArticleNature cancer2026

Diagnostic accuracy, fairness and clinical implementation of AI for breast cancer screening: results of multicenter retrospective and prospective technical feasibility studies.

Christopher J Kelly, Marc Wilson, Lucy M Warren, Richard Sidebottom, Mark Halling-Brown, Lin Yang, Megumi Morigami, Jenny Venton, Reena Chopra, Jane Chang and 28 more

Abstract readMulticenter Study
In one paragraph

Article in Nature cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
  6. AI for breast cancer screening.Nature cancer · 2026
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors.

Christopher J Kelly *Google Research, Mountain View, CA, USA. christopher.kelly1@nhs.net.ORCID http://orcid.org/0000-0002-1246-844X
Marc Wilson *Google Research, Mountain View, CA, USA.
Lucy M WarrenRoyal Surrey NHS Foundation Trust, Guildford, UK.ORCID http://orcid.org/0000-0002-8296-8917
Richard SidebottomGoogle Research, Mountain View, CA, USA.ORCID http://orcid.org/0000-0003-0063-8082
Mark Halling-BrownRoyal Surrey NHS Foundation Trust, Guildford, UK.
Lin YangGoogle Research, Mountain View, CA, USA.
Megumi MorigamiGoogle Research, Mountain View, CA, USA.
Jenny VentonRoyal Surrey NHS Foundation Trust, Guildford, UK.ORCID http://orcid.org/0000-0003-0547-1226
Reena ChopraGoogle Research, Mountain View, CA, USA.ORCID http://orcid.org/0000-0002-4264-8329
Jane ChangGoogle Research, Mountain View, CA, USA.
Jonathan DixonGoogle Research, Mountain View, CA, USA.
Fiona J GilbertUniversity of Cambridge, Cambridge, UK.
Daniel I GoldenGoogle Research, Mountain View, CA, USA.ORCID http://orcid.org/0000-0002-1114-3184
Elzbieta GruzewskaGoogle Research, Mountain View, CA, USA.ORCID http://orcid.org/0009-0003-1594-3335
Lesley HoneyfieldImperial College Healthcare NHS Trust, London, UK.
Amandeep HujanSt George's University Hospitals NHS Foundation Trust, London, UK.
Delara KhodabakhshiSt George's University Hospitals NHS Foundation Trust, London, UK.
Emma LewisRoyal Surrey NHS Foundation Trust, Guildford, UK.
Namrata MalhotraImperial College London, London, UK.
Rachita MallyaImperial College London, London, UK.
Della OgunleyeAIMS Public Engagement Group, London, UK.
Charlotte PurdyAIMS Public Engagement Group, London, UK.
Rory SayresGoogle Research, Mountain View, CA, USA.ORCID http://orcid.org/0000-0002-8269-5779
Marcin SieniekGoogle Research, Mountain View, CA, USA.
Tsvetina StoychevaImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0009-0000-5506-3859
Aminata SyImperial College London, London, UK.
Susan ThomasGoogle Research, Mountain View, CA, USA.
Dominic WardRoyal Surrey NHS Foundation Trust, Guildford, UK.
Lihong XiGoogle Research, Mountain View, CA, USA.
Shawn XuGoogle Research, Mountain View, CA, USA.
Shravya ShettyGoogle Research, Mountain View, CA, USA. sshetty@google.com.ORCID http://orcid.org/0000-0003-3783-3172
Ara DarziImperial College London, London, UK.
Kenneth YoungRoyal Surrey NHS Foundation Trust, Guildford, UK.ORCID http://orcid.org/0000-0003-3491-257X
Hema PurushothamanSt George's University Hospitals NHS Foundation Trust, London, UK.
Lisanne KhooSt George's University Hospitals NHS Foundation Trust, London, UK.
Mamatha ReddySt George's University Hospitals NHS Foundation Trust, London, UK.
Hutan AshrafianImperial College London, London, UK. h.ashrafian@imperial.ac.uk.ORCID http://orcid.org/0000-0003-1668-0672
Deborah CunninghamImperial College Healthcare NHS Trust, London, UK. deborah.cunningham1@nhs.net.ORCID http://orcid.org/0000-0001-9542-7880

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Artificial intelligence (AI) promises to enhance breast cancer screening. Here we evaluated Google's mammography AI system (version 1.2) across two phases: a retrospective study using 115,973 mammograms from five National Health Service screening services with 39-month follow-up and prospective noninterventional feasibility deployment at 12 sites (9,266 cases). The primary endpoint was AI sensitivity and specificity versus first reader using a 5% noninferiority margin. The secondary endpoints were performance versus second or consensus readers and breast-level analyses. Retrospectively, AI achieved superior sensitivity (0.541 versus 0.437 for first reader, P < 0.001) and noninferior specificity (0.943 versus 0.952, P < 0.001). Cancer detection rate increased from 7.54 to 9.33 per 1,000 women, with AI detecting 25.0% of interval cancers. Performance was particularly strong for first screens (39.3% fewer recalls, 8.8% higher detection) and invasive cancers. No systematic demographic disparities were observed. Simulated second-reader replacement reduced reading time by 32% while increasing detection by 17.7%. Prospective deployment confirmed technical feasibility but revealed a distribution shift requiring threshold recalibration. Implementation requires adaptive calibration and continuous monitoring to ensure safety and equity.

Indexed as

Artificial IntelligenceBreast NeoplasmsEarly Detection of CancerMammographyAgedFeasibility StudiesFemaleHumansMiddle AgedProspective StudiesRetrospective StudiesSensitivity and Specificity

Identifiers

PMID41807818
PMCPMC13035471

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.