Who wants cancer screening with PET? A contingent valuation survey in Japan

Cancer screening using whole-body fluorodeoxyglucose-positron emission tomography (FDG-PET) has gradually become popular in Japan. Although some studies have reported high cancer detection rates with PET screening, the justification for such an approach is still unclear, and no evidence has been provided to indicate that PET screening reduces cancer mortality. We measured the general public's willingness to pay (WTP) for this service using a contingent valuation method, after providing them with sufficient information regarding the efficacy and limitations of the service.

A computer-assisted questionnaire survey was conducted on males and females in Japan aged between 40 and 59 years. The study participants (n=390) were provided with sufficient information about the PET procedure, the high cancer detection rate, false-negatives/false-positives and the fact that the mortality-reducing effect of PET screening has not yet been demonstrated. The participants' WTP was ascertained by a double-bound dichotomous choice approach.

The average WTP among all the participants was $68.0 (95% confidence interval: $56.9-79.2). A Weibull regression analysis showed that income, degree of concern about health, and family history of cancer were significant factors affecting WTP.

The actual charge for PET screening in Japan is approximately $1000 on average, which is significantly higher than the participants' WTP for the actual benefit obtained from the service. If the Japanese healthcare consumers are well-informed, most of them would avoid purchasing such a costly service.