Abstract
BackgroundIt is very necessary to implement gastric cancer screening in China to reduce the mortality of gastric cancer, but there are no national screening guidelines and programs. Understanding of individual preferences is conducive to formulating more acceptable screening strategies, and discrete choice experiments can quantify individual preferences. In addition, the first-degree relatives of gastric cancer patients are at high risk for gastric cancer. Compared with those without a family history of gastric cancer, the risk of gastric cancer in first-degree relatives of gastric cancer patients is increased by 60%. Therefore, a discrete choice experiment was carried out to quantitatively analyse the preferences of first-degree relatives of gastric cancer patients for gastric cancer screening to serve as a reference for the development of gastric cancer screening strategies.MethodsA questionnaire was designed based on a discrete choice experiment, and 342 first-degree relatives of gastric cancer patients were investigated. In STATA 15.0 software, the data were statistically analysed using a mixed logit model.ResultsThe five attributes included in our study had a significant influence on the preferences of first-degree relatives of gastric cancer patients for gastric cancer screening (P < 0.05). Participants most preferred the sensitivity of the screening program to be 95% (coefficient = 1.424, P < 0.01) with a willingness to pay 2501.902 Yuan (95% CI, 738.074–4265.729). In addition, the participants’ sex and screening experiences affected their preferences. An increase in sensitivity 35 to 95% had the greatest impact on the participants’ willingness to choose a gastric cancer screening program.ConclusionThe formulation of gastric cancer screening strategies should be rooted in people’s preferences. The influence of sex differences and screening experiences on the preferences of people undergoing screening should be considered, and screening strategies should be formulated according to local conditions to help them play a greater role.
Highlights
It is very necessary to implement gastric cancer screening in China to reduce the mortality of gastric cancer, but there are no national screening guidelines and programs
To our knowledge, this work presents the first discrete choice experiment (DCE) examining the preferences of first-degree relatives (FDRs) of gastric cancer patients for gastric cancer screening and the screening programme-related characteristics that could motivate them to accept one programme over another
We found sensitivity and pain to be highly valued by FDRs of gastric cancer patients, who were willing to pay more for higher sensitivity and less pain
Summary
It is very necessary to implement gastric cancer screening in China to reduce the mortality of gastric cancer, but there are no national screening guidelines and programs. The first-degree relatives of gastric cancer patients are at high risk for gastric cancer. Even when patients with advanced gastric cancer receive surgical treatment, the 5-year survival rate is still less than 30% [1]. Sumiyama’s research showed that the 5-year survival rate of patients with early gastric cancer can exceed 90% after treatment and that such patients can even achieve remission [2]. The implementation of gastric cancer screening to reduce the gastric cancer incidence and mortality in China is a public health issue that urgently needs to be resolved, but no national screening guidelines or programmes are in place [6]. “Three-year Action Plan for Cancer Prevention and Control in China (2015-2017)” clearly states that cancer screening and early diagnosis and treatment strategies in China need to be promoted and improved [7]
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