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Evidence-based consumer choice: a case study in colorectal cancer screening
Glenn Salkeld1, Michael Solomon, Leonie Short
1Screening Test Evaluation Program, School of Public Health, Surgical Outcomes Research Centre, University of Sydney, A27, NSW 2006. glenns@health.usyd.edu.au
Australian and New Zealand Journal of Public Health
|January 7, 2004
Summary
Community preferences for colorectal cancer (CRC) screening using faecal occult blood tests (FOBT) reveal varied trade-offs between benefits and harms. Policymakers should consider these insights for national screening program design.
Area of Science:
- Public Health
- Health Services Research
- Behavioral Science
Background:
- Colorectal cancer (CRC) screening is crucial for early detection and improved survival rates.
- Faecal occult blood tests (FOBT) are a common method for CRC screening.
- Understanding community preferences is vital for effective public health program design.
Purpose of the Study:
- To determine community preferences for CRC screening via FOBT using discrete choice modeling (DCM).
- To inform the design of a national CRC screening program by eliciting public priorities regarding screening attributes.
Main Methods:
- A discrete choice study was conducted with 301 participants (aged 50-70) in Sydney, Australia.
- Participants at average CRC risk were interviewed face-to-face, presented with screening profiles.
- Preferences were estimated by varying screening characteristics: benefit (deaths prevented), harm (colonoscopy), and notification policy.
Main Results:
- 32% of respondents prioritized CRC deaths prevented above all else; 12% opted for no screening.
- The majority (56%) were willing to accept trade-offs, with 164 participants accepting 853 colonoscopies for one CRC death prevented.
- Community support for CRC screening is unlikely to be unanimous, regardless of harm reduction.
Conclusions:
- Community support for CRC screening is not absolute, with varying individual priorities on survival benefits versus potential harms.
- Insights into community assessment of CRC screening benefits, harms, and costs are essential for future national programs.
- Policymakers must consider diverse public preferences when developing and implementing CRC screening strategies.