Patient Preferences for a Blood-Based Colorectal Cancer Screening Test: Insights From a Conjoint Analysis Survey

Over one-third of people are not up-to-date with colorectal cancer (CRC) screening, and blood-based tests offer a promising alternative to existing options. We used conjoint analysis to quantify the proportion of people who would prefer a hypothetical blood test over current methods (e.g., fecal immunochemical test, multitarget stool DNA test, colonoscopy).

We conducted a conjoint analysis survey in a US nationally representative sample of average risk individuals aged 40-75 years who were not up-to-date with CRC screening. We performed latent class analysis to identify groups with similar decision-making profiles and estimated the proportion who would prefer a blood test every 3 years over existing methods.

Overall, 1,009 participants completed the survey. Using latent class analysis, we identified 2 distinct groups: (i) prioritized how the test is performed-39.4%, and (ii) prioritized the accuracy of detecting CRC and advanced adenomas-60.6%. Through simulations using the conjoint data, most individuals in the first group preferred a blood test every 3 years (65.1%), whereas 53.0% of the second group also favored the blood test. In additional simulations that incorporated test accuracy for CRC and advanced adenoma detection, these performance characteristics emerged as important drivers of screening preferences across the different testing options.

Among individuals not up-to-date with CRC screening, our findings suggest that many would generally prefer a blood-based screening test over other options, but preference may depend on test accuracy. Offering a blood test option may improve CRC screening uptake, particularly among individuals who are unscreened or overdue for screening.