Preferences for potential innovations in non-invasive colorectal cancer screening: A labeled discrete choice experiment for a Dutch screening campaign

Abstract

Background. The introduction of innovative non-invasive screening tests (e.g. tests based on stool and blood samples or both) may be a solution to increase colorectal cancer (CRC) screening uptake. However, preferences for these non-invasive screening tests have not been investigated in great detail yet. The purpose of this article therefore is to elicit individuals’ preferences for different non-invasive screening tests in a Dutch screening campaign context.

Material and methods. We investigate preferences by means of a labeled discrete choice experiment. Data of 815 individuals, aged 55–75 years, are used in the analysis.

Results. Multinomial logit model analysis showed that the combi-test is generally preferred over the blood-test and the (currently available) stool-test. Furthermore, besides the large effect of screening test type, there are significant differences in preference depending on participants’ socio-demographic background. Finally, the analysis showed a significant positive effect on screening test choice for the attributes sensitivity, risk reduction, and level of evidence and a non-significant effect for the attribute unnecessary follow-up test.

Conclusion. Introducing new non-invasive screening tests that are based on a combination of stool and blood samples (or blood sample only) has the potential to increase CRC screening participation compared to the current standard stool-based test.

Acknowledgements

Comments by seminar participants in presentations at the institute of Health Policy & Management (iBMG) and the annual DeCoDe and CTMM meetings (2011 and 2012) are highly appreciated. Furthermore, we thank Marjolein van Ballegooien, Esther de Bekker-Grob, and Luuk Goede for their interview and assistance with the selection of attributes and attribute levels and Manon van Engeland and Veerle Melotte for clarifying screening test information. We also thank Gerrit Meijer and Carin Uyl-de Groot for their helpful suggestions.

Declaration of interest: The views expressed and any flaws remain the full responsibility of the authors. This study was performed within the framework of CTMM, the Center for Translational Molecular Medicine. DeCoDe project (grant 03O-101). The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.