Barriers to Use of mHealth Apps for Skin Cancer Screening

Cell phone in woman's hand
Cell phone in woman’s hand
Researchers sought to learn the views of the Dutch general population regarding perceived barriers and facilitators for use of mHealth apps for skin cancer screening.

Perceived value, trustworthiness, privacy, design, and costs are important barriers and facilitators regarding use of mobile health applications (mHealth apps) for skin cancer screening, according to study findings published in the British Journal of Dermatology.

This study included 4 focus groups with a total of 27 participants (age range, 19-71 years; 18 women). A 2-stage purposive sampling method was used for participant selection, aiming for variation in sex, age, and prior experience with mHealth.

The 4 focus groups were led by an experienced moderator and a topic guide was used to structure the discussion. The focus group meetings were transcribed verbatim and analyzed by 2 researchers using several coding phases.

Findings from the focus groups revealed 6 main barriers and 5 main facilitators regarding use of mHealth for skin cancer screening. The barriers were a perceived lack of value, perception of untrustworthiness, preference for a doctor, privacy concerns, a complex user interface, and high costs.

The main factors facilitating use of mHealth in the general population were a high perceived value, a transparent and trustworthy identity of app developers, endorsement by healthcare providers and government regulating bodies, ease of use, and low or no cost of use.

Based on these results, the researchers recommended that clear communication about the reliability of the provided screening and its associated benefits and drawbacks, as well as ensuring a low cost of use, could help improve adoption and use of mHealth for skin cancer.

The study authors also suggested that design and functionality could be improved by developing privacy-friendly, easy-to-use apps for all ages, and that integration with existing healthcare systems could be improved through collaboration with and endorsement from healthcare professionals and government regulating bodies.

Among several limitations to their findings, the investigators noted that their study focused on perceived barriers to and facilitators of mHealth for skin cancer screening, which depended on participants’ perception and may not fully reflect the range of barriers and facilitators associated with actual use of mHealth. Also, characteristics such as age varied among the participants, and the sample population was from a customer panel from a Dutch health insurer.

“As artificial intelligence development in mHealth apps for skin cancer screening progresses rapidly, it is vital to consider the public’s perspective on this innovative technology,” the researchers commented. “The results of this study may be useful for app developers and healthcare professionals as they seek to improve acceptance and integration of mHealth in skin cancer care.”

Disclosure: The Department of Dermatology of the Erasmus MC Cancer Institute, which is the affiliation of 4 of the study authors, has received an unrestricted research grant from SkinVision. One of the study authors declared an affiliation with SkinVision.


Sangers TE, Wakkee M, Kramer-Noels EC, Lugtenberg M. Views on mobile health apps for skin cancer screening in the general population: an in-depth qualitative exploration of perceived barriers and facilitators. Br J Dermatol. Published online May 7, 2021. doi:10.1111/bjd.2044