Individual Preference for Fecal Immunochemical Test Options among Younger Adults: A Discrete Choice Experiment

Area of Science:

• Public Health
• Health Economics
• Preventive Medicine

Background:

• Colorectal cancer (CRC) screening is crucial for early detection and mortality reduction.
• Understanding preferences for screening methods like fecal immunochemical test (FIT) among younger adults (<50) is vital for effective public health strategies.
• Disparities in screening uptake necessitate research into subgroup preferences.

Purpose of the Study:

• To quantify preferences for fecal immunochemical test (FIT) attributes among adults under 50 for colorectal cancer (CRC) screening.
• To identify how preferences for FIT vary across different demographic and health-related subgroups.
• To estimate the marginal willingness-to-pay for various FIT attributes.

Main Methods:

• A discrete choice experiment (DCE) was employed with adults aged <50 in Hong Kong.
• Mixed logit and latent class models were utilized to analyze preference heterogeneity.
• Analysis included estimation of marginal willingness-to-pay for attribute level changes.

Main Results:

• Mortality reduction was the most significant attribute influencing FIT acceptance, followed by testing frequency and early detection likelihood.
• FIT acceptance was sensitive to out-of-pocket payment amounts.
• Latent class analysis revealed significant preference variations based on age, education, and self-reported health status.

Conclusions:

• A majority of adults under 50 are willing to consider FIT for CRC screening, provided suitable options exist.
• Emphasizing mortality reduction in communication strategies may enhance screening uptake.
• Financial subsidies and tailored approaches considering individual preferences are recommended to improve FIT acceptance.