title: [Acceptance and willingness-to-pay for colorectal colonoscopy screening among high-risk populations for colorectal cancer in urban China].
abstract: OBJECTIVE
  To survey the acceptance and willingness-to-pay for colorectal cancer colonoscopy screening among high risk populations in urban China.
  
  
  METHODS
  From 2012 to 2013, a Cancer Screening Program in Urban China (CanSPUC) was initiated in 9 provinces, the current survey was conducted among those participants who were evaluated as "high risk for colorectal cancer" by a risk-factor-evaluation-model (community-based) and then went through a colonoscopy screening procedure (hospital-based). All the data were obtained through a questionnaire-based interview (face-to-face or self-completed), mainly focusing on the acceptance and willingness-to-pay of the participants for colorectal colonoscopy screening.
  
  
  RESULTS
  The current analysis included a total of 1 624 participants, with an median age of 55.0 years (P25 = 49.0, P75 = 61.0 years) and an annual income per capita of 17 thousand (range: 10-25 thousand) Chinese Yuan (CNY), 42.8% (695/1 624) of whom were males. Of all the participants, 87.0% (1 414/1 624) could totally or substantially accept the colonoscopy screening, particularly in those at higher education level (junior high school: OR = 0.34, 95% CI: 0.22-0.52; high school OR = 0.41, 95% CI: 0.26-0.66; college or over OR = 0.35, 95% CI: 0.20-0.59). Of all the participants, 13.0% (210/1 624) could not or hardly accept it, particularly in those with older age (60-69 years) (OR = 1.48, 95% CI: 1.06-2.07), not in marriage (OR = 2.15, 95% CI: 1.25-3.70) or with family member(s) to raise (OR = 1.60, 95% CI: 1.17-2.20). 1 388 (85.5%) of all the participants had willingness-to-pay for a long-term colonoscopy screening service, particularly in those working in public (OR = 0.61, 95% CI: 0.44-0.84) or enterprise sectors (OR = 0.60, 95% CI: 0.38-0.94), but 82.3% (1 141/1 386) of whom would only pay less than 100 CNY; 14.5% (236/1 624) of total had no willingness-to-pay, particularly in those living in areas with moderate (OR = 4.08, 95% CI: 2.75-6.33) or high GDP per capita (OR = 3.26, 95% CI: 2.11-4.92), or with an absence of willingness-to-pay for colonoscopy screening (OR = 3.98, 95% CI: 2.81-5.65).
  
  
  CONCLUSIONS
  Although a larger community-based colorectal cancer screening program was warranted to examine the extrapolation of these findings, it suggested that the acceptance for colorectal cancer colonoscopy screening among the selected high-risk populations was considerable. The willing-to-pay was relatively high but the amount of payment was limited, the indicated subgroups with potentially less acceptance or willingness need to be more focused in the future to reach a higher participation rate. The data will also be informative in integrating the screening service into the local health insurance system.
authors.affiliation: Office for Cancer Screening Program in Urban China & National Office for Cancer Prevention and Control, National Cancer Center of China, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Jufang
authors.initials: J
authors.lastname: Shi
authors.forename: Huiyao
authors.initials: H
authors.lastname: Huang
authors.forename: Lanwei
authors.initials: L
authors.lastname: Guo
authors.forename: Jiansong
authors.initials: J
authors.lastname: Ren
authors.forename: Ying
authors.initials: Y
authors.lastname: Ren
authors.forename: Li
authors.initials: L
authors.lastname: Lan
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhou
authors.forename: Ayan
authors.initials: A
authors.lastname: Mao
authors.forename: Xiao
authors.initials: X
authors.lastname: Qi
authors.forename: Xianzhen
authors.initials: X
authors.lastname: Liao
authors.forename: Guoxiang
authors.initials: G
authors.lastname: Liu
authors.forename: Yana
authors.initials: Y
authors.lastname: Bai
authors.forename: Rong
authors.initials: R
authors.lastname: Cao
authors.forename: Yuqin
authors.initials: Y
authors.lastname: Liu
authors.forename: Yuanzheng
authors.initials: Y
authors.lastname: Wang
authors.forename: Jiyong
authors.initials: J
authors.lastname: Gong
authors.forename: Ni
authors.initials: N
authors.lastname: Li
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: He
authors.affiliation: Email: daimin2002@hotmail.com.
authors.forename: Min
authors.initials: M
authors.lastname: Dai
mesh_terms: D002681:China; D003113:Colonoscopy; D015179:Colorectal Neoplasms; D003625:Data Collection; D003710:Demography; D055088:Early Detection of Cancer; D005190:Family; D005249:Fees and Charges; D005260:Female; D006801:Humans; D007182:Income; D007348:Insurance, Health; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014505:Urban Population