title: Difference in willingness-to-pay for prostate cancer screening between ill-informed and well-informed men: a contingent valuation survey.
abstract: OBJECTIVE
  To use a contingent valuation method to compare the willingness of well-informed and ill-informed men to pay for PSA screening. Prostate cancer screening by analysis of prostate-specific antigen (PSA) levels has recently been confirmed to reduce prostate cancer death. However, PSA screening is associated with considerable risks, and men should be well informed about the risks before deciding to undergo the test.
  
  
  METHODS
  A total of 1800 men aged 50-69 years old participated in an Internet-based, computer-assisted questionnaire survey. The subjects were randomly divided into 2 groups. Group 1 (n = 900) was provided with information about the procedure, detection rate, and mortality-reducing effects of PSA screening. Additional information was given to group 2 (n = 900), including the possibility of false-positive or false-negative results, the risks of close examination, and the possibility of overdiagnoses. The willingness to pay (WTP) was assessed using a double-bound dichotomous choice method.
  
  
  RESULTS
  The average WTP was significantly greater in group 1 than in group 2 ($31.1 vs $25.1, P < .01). Weibull regression analysis showed that patients with a history of receiving PSA screening or with greater incomes had a significantly greater WTP.
  
  
  CONCLUSIONS
  Although providing information on the risks of PSA screening significantly decreased men's WTP for such tests, the well-informed group was still willing to pay $25.1. These findings suggest that men can balance the potential disadvantages of PSA screening against its effectiveness in saving lives.
authors.affiliation: Department of Health Management and Policy, University of Tokyo Graduate School of Medicine, Tokyo, Japan. yasunagah-jyo@h.u-tokyo.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Toru
authors.initials: T
authors.lastname: Sugihara
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Imamura
mesh_terms: D000368:Aged; D001294:Attitude to Health; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods*; D004470:Economics, Medical; D005189:False Positive Reactions; D017048:Health Care Costs; D006801:Humans; D020407:Internet; D007564:Japan; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000191:economics*; D012044:Regression Analysis; D011795:Surveys and Questionnaires
chemical_list: D017430:Prostate-Specific Antigen