title: Patient preferences of a resect and discard paradigm.
abstract: BACKGROUND
  Resect and discard is a new paradigm for management of diminutive polyps. It is unknown whether patients will embrace this new paradigm in which small polyps would not be sent for histopathologic review.
  
  
  OBJECTIVE
  To determine whether patients would be willing to pay for pathology costs with their own money and which factors influence patients' decisions to pay or not pay for pathology costs with their own money.
  
  
  METHODS
  Single-center, prospective, survey study.
  
  
  METHODS
  Hospital outpatient endoscopy center.
  
  
  METHODS
  Adults undergoing colonoscopy for screening or routine polyp surveillance.
  
  
  METHODS
  Patient survey.
  
  
  METHODS
  Willingness to pay out-of-pocket for pathology costs when a diminutive polyp is found and factors that influence patients' decisions to pay or not pay for pathology costs with their own money.
  
  
  RESULTS
  A total of 500 participants completed the survey. A total of 360 respondents (71.9%) indicated a hypothetical willingness to pay out-of-pocket for histopathologic polyp analysis if this interpretation was not covered by insurance. Patient factors significantly associated with willingness to pay for polyp analysis included higher income and education and female sex.
  
  
  CONCLUSIONS
  Single center, hypothetical situation.
  
  
  CONCLUSIONS
  Over two-thirds of patients were willing to pay to have their diminutive polyp sent for pathologic evaluation if their insurance carrier would not pay the cost. Factors associated with willingness to pay included higher income, higher education, and female sex. Patients who were unwilling to pay raised concerns about cost and are less concerned about cancer risk compared with those willing to pay. (
  
  
  BACKGROUND
  NCT02305251.).
authors.affiliation: Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Hongha T
authors.initials: HT
authors.lastname: Vu
authors.affiliation: Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Sayuk
authors.affiliation: Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Neil
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hollander
authors.affiliation: Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Aram
authors.initials: A
authors.lastname: Kim
authors.affiliation: Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Dayna S
authors.initials: DS
authors.lastname: Early
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D000368:Aged; D001706:Biopsy / Q000191:economics; D003111:Colonic Polyps / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D003113:Colonoscopy / Q000379:methods / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D008297:Male; D017744:Medical Waste Disposal; D008875:Middle Aged; D010338:Pathology, Clinical / Q000191:economics; D057240:Patient Preference / Q000191:economics / Q000523:psychology*; D011446:Prospective Studies; D013048:Specimen Handling; D011795:Surveys and Questionnaires
chemical_list: D017744:Medical Waste Disposal