Demand for Cancer Screening Services: Results From Randomized Controlled Discrete Choice Experiments

Area of Science:

• Public Health
• Health Economics
• Cancer Prevention

Background:

• Low uptake of cancer screening services is a significant global public health challenge.
• Understanding factors influencing screening decisions is crucial for improving cancer prevention strategies.

Purpose of the Study:

• To investigate factors influencing women's decisions regarding cancer screening (mammography and Pap smear) in Singapore.
• To evaluate the impact of screening/treatment subsidies and gain-framed messages on screening uptake.

Main Methods:

• Discrete choice experiments were used to analyze preferences for mammography and Pap smear among women.
• Respondents were randomly exposed to a gain-framed public health message promoting screening benefits.

Main Results:

• The gain-framed message did not significantly influence stated screening uptake.
• Respondents prioritized treatment attributes (effectiveness, out-of-pocket costs) over screening attributes (monetary incentives).
• Underestimation of survival chances for screen-detected breast and cervical cancers was observed.

Conclusions:

• Correcting misconceptions about cancer prognosis post-screening may be more effective than direct screening subsidies.
• Enhancing financial protection for individuals testing positive could increase screening uptake cost-effectively.
• Public health interventions should consider both patient perceptions and financial implications.