title: Stated Preference for Cancer Screening: A Systematic Review of the Literature, 1990-2013.
abstract: BACKGROUND
  Stated-preference methods provide a systematic approach to quantitatively assess the relative preferences for features of cancer screening tests. We reviewed stated-preference studies for breast, cervical, and colorectal cancer screening to identify the types of attributes included, the use of questions to assess uptake, and whether gaps exist in these areas. The goal of our review is to inform research on the design and promotion of public health programs to increase cancer screening.
  
  
  METHODS
  Using the PubMed and EconLit databases, we identified studies published in English from January 1990 through July 2013 that measured preferences for breast, cervical, and colorectal cancer screening test attributes using conjoint analysis or a discrete-choice experiment. We extracted data on study characteristics and results. We categorized studies by whether attributes evaluated included screening test, health care delivery characteristics, or both.
  
  
  RESULTS
  Twenty-two studies met the search criteria. Colorectal cancer was the most commonly studied cancer of the 3. Fifteen studies examined only screening test attributes (efficacy, process, test characteristics, and cost). Two studies included only health care delivery attributes (information provided, staff characteristics, waiting time, and distance to facility). Five studies examined both screening test and health care delivery attributes. Overall, cancer screening test attributes had a significant effect on a patient's selection of a cancer screening test, and health care delivery attributes had mixed effects on choice.
  
  
  CONCLUSIONS
  A growing number of studies examine preferences for cancer screening tests. These studies consistently find that screening test attributes, such as efficacy, process, and cost, are significant determinants of choice. Fewer studies have examined the effect of health care delivery attributes on choice, and the results from these studies are mixed. There is a need for additional studies on the barriers to cancer screening uptake, including health care delivery attributes, and the effect of education materials on preferences.
authors.affiliation: RTI Health Solutions, RTI International, Research Triangle Park, North Carolina.
authors.forename: Carol
authors.initials: C
authors.lastname: Mansfield
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS F-76, Atlanta, GA 30341. Email: ftangka@cdc.gov.
authors.forename: Florence K L
authors.initials: FK
authors.lastname: Tangka
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Judith Lee
authors.initials: JL
authors.lastname: Smith
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Chunyu
authors.initials: C
authors.lastname: Li
authors.affiliation: RTI Health Solutions, RTI International, Research Triangle Park, North Carolina.
authors.forename: A Brett
authors.initials: AB
authors.lastname: Hauber
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis; D002755:Choice Behavior; D015179:Colorectal Neoplasms / Q000175:diagnosis; D003695:Delivery of Health Care / Q000592:standards*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D057240:Patient Preference; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis