The use of generative AI tools among individuals with cancer and their caregivers: a cross-sectional study of awareness, attitudes, and experiences.

BACKGROUND: Generative artificial intelligence (AI) tools offer novel avenues for patient support, yet data on their adoption in oncology remain limited. This study measured awareness, attitudes, and usage patterns of AI tools among individuals diagnosed with cancer and informal caregivers to inform clinical integration. METHODS: A descriptive, cross-sectional study was conducted at a tertiary oncology center. Adult patients and their caregivers completed anonymous, structured questionnaires assessing sociodemographics, digital literacy, AI usage patterns, and perceptions. Multivariate logistic regression identified independent predictors of AI use. RESULTS: A total of 400 participants (68% patients, mean age 61 years; 32% caregivers, mean age 54 years) were included. While 75% were aware of AI tools, only 24% used them for cancer-related information. Multivariate analysis revealed that university-level education (adjusted odds ratio [aOR] = 4.47, p < 0.001), younger age (≤ 55 years; aOR = 2.64, p < 0.001) and recent diagnosis (< 1 year; aOR = 2.16, p = 0.003) were independent predictors of AI use. Caregivers used AI more regularly than patients and usage motivations diverged significantly. Notably, 69% of users did not disclose AI use to their physician. However, 73% of all participants expressed willingness to use AI if verified by their physician, and no users reported decreased trust in their oncologists. CONCLUSIONS: Generative AI usage remains moderate and largely undisclosed ("silent usage"), driven by a distinct digital divide based on education and age. While patients and caregivers desire physician-verified tools, oncologists must proactively invite open, non-judgmental discussions about AI usage to clinically verify patients' findings, mitigate misinformation risks and ensure safe integration into clinical practice.