Patient Preferences Regarding Colorectal Cancer Screening: Test Features and Cost Willing to Pay Out of Pocket

• Published in: Current problems in diagnostic radiology Vol. 45; no. 3; pp. 189 - 192
• Main Authors: Moreno, Courtney C., MD, Weiss, Paul S., MS, Jarrett, Thomas L., MD, Roberts, David L., MD, Mittal, Pardeep K., MD, Votaw, John R., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2016
• Subjects: Aged; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - economics; Early Detection of Cancer - economics; Early Detection of Cancer - statistics & numerical data; Female; Humans; Internal Medicine; Male; Middle Aged; Patient Preference - economics; Patient Preference - statistics & numerical data; Pilot Projects; Radiology; Surveys and Questionnaires
• ISSN: 0363-0188; 1535-6302
• DOI: 10.1067/j.cpradiol.2015.12.002

The purpose of this investigation was to evaluate whether test features would make an individual more or less likely to undergo colorectal cancer screening and how much an individual would be willing to pay out of pocket for a screening test. The methods include an administration of a survey to consecutive adult patients of a general medicine clinic. The survey consisted of Likert-scale questions assessing the patients’ likelihood of choosing a screening test based on various test characteristics. Additional questions measured the patients’ age, race, gender, and maximum out-of-pocket cost they would be willing to pay. Chi-square tests were used to assess the associations between the likelihood questions and the various demographic characteristics. In results, survey response rate was 88.8% (213 of 240). Respondents were 48.4% female (103 of 213), 51.6% male (110 of 213), 82.6% White (176 of 213), 11.3% African-American (24 of 213), and 6.1% other (13 of 213). Risk of internal injury and light exposure to radiation were the least desirable test features. Light sedation was the only test feature that most respondents (54.8%) indicated would make them likely or very likely to undergo a colorectal cancer screening test. The vast majority of respondents (86.8%) were willing to pay less than $200 out of pocket for a colorectal cancer screening test. There was no statistically significant difference in the responses of males and females, or in the responses of individuals of different races or different ages regarding test features, or the amount individuals were willing to pay for a screening test. To conclude, survey results suggest that patient education emphasizing the low complication rate of computed tomographic colonography (CTC), the minimal risks associated with the low-level radiation exposure resulting from CTC, and the benefits of a sedation-free test (eg, no risk of sedation-related complication and no need for a driver) may increase patient acceptance of CTC. Additionally, an out-of-pocket cost of <$200 would be preferable from the patient perspective.