title: Public stated preferences and predicted uptake for genome-based colorectal cancer screening.
abstract: BACKGROUND
  Emerging developments in nanomedicine allow the development of genome-based technologies for non-invasive and individualised screening for diseases such as colorectal cancer. The main objective of this study was to measure user preferences for colorectal cancer screening using a nanopill.
  
  
  METHODS
  A discrete choice experiment was used to estimate the preferences for five competing diagnostic techniques including the nanopill and iFOBT. Alternative screening scenarios were described using five attributes namely: preparation involved, sensitivity, specificity, complication rate and testing frequency. Fourteen random and two fixed choice tasks, each consisting of three alternatives, were offered to 2225 individuals. Data were analysed using the McFadden conditional logit model.
  
  
  RESULTS
  Thirteen hundred and fifty-six respondents completed the questionnaire. The most important attributes (and preferred levels) were the screening technique (nanopill), sensitivity (100%) and preparation (no preparation). Stated screening uptake for the nanopill was 79%, compared to 76% for iFOBT. In the case of screening with the nanopill, the percentage of people preferring not to be screened would be reduced from 19.2% (iFOBT) to 16.7%.
  
  
  CONCLUSIONS
  Although the expected benefits of nanotechnology based colorectal cancer screening are improved screening uptake, assuming more accurate test results and less preparation involved, the relative preference of the nanopill is only slightly higher than the iFOBT. Estimating user preferences during the development of diagnostic technologies could be used to identify relative performance, including perceived benefits and harms compared to competitors allowing for significant changes to be made throughout the process of development.
authors.affiliation: Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology & Technical Medicine, University of Twente, P,O, box 217, 7500 AE, Enschede, The Netherlands. c.g.m.oudshoorn@utwente.nl.
authors.forename: Catharina G M
authors.initials: CG
authors.lastname: Groothuis-Oudshoorn
authors.forename: Jilles M
authors.initials: JM
authors.lastname: Fermont
authors.forename: Janine A
authors.initials: JA
authors.lastname: van Til
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Ijzerman
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics; D003258:Consumer Behavior; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D005260:Female; D015894:Genome, Human; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D050997:Nanomedicine / Q000592:standards*; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D012680:Sensitivity and Specificity; D006113:United Kingdom