Assessing Women’s Preference and Willingness to Pay for Breast Cancer Screening: A Discrete Choice Experiment Approach

Abstract

Objectives

This study aimed to explore women’s preferences regarding breast cancer screening using a discrete choice experiment and willingness-to-pay analysis.

Methods

A discrete-choice experiment was conducted among 255 women aged 40 to 65 years who were referred to health centers in Tehran city. The experiment included attributes such as screening methods (clinical examination and mammography), number of deaths prevented, possibility of misdiagnosis and unnecessary biopsy, screening intervals, and cost of the screening test. A conditional logit model was used to estimate preferences, and willingness-to-pay values were derived from the model coefficients.

Results

Women revealed a strong preference for mammography over clinical examination(odds ratio [OR] 1.73; 95% CI 1.47-2.04; P < .001). Compared with 1 death prevented per 1000 women, the ORs for 3 and 6 deaths prevented per 1000 women were 18.1 (95% CI 12.72-25.75; P < .001) and 74.48 (95% CI 49.41-112.27; P < .001), respectively. The ORs for misdiagnosis and unnecessary biopsy rates of 10 of 100 people were 0.006 (95% CI 0.003-0.012; P < .001). Preferences for screening intervals varied, with a higher preference for screening every 4 years (OR 2.77; 95% CI 1.73-4.43; P < .001) compared with annual screening. The cost was also a significant factor, with a decrease in the odds of choosing a screening option as the cost increased (OR 0.139; 95% CI 0.1396-0.1399; P = .001).

Conclusions

This study provides valuable insights into women’s preferences for breast cancer screening in Iran.