Patient Preferences in Treatment Choices for Early-Stage Lung Cancer.
BACKGROUND
Decision-making for lung cancer treatment can be complex because it involves both provider recommendations based on the patient's clinical condition and patient preferences. This study describes the relative importance of several considerations in lung cancer treatment from the patient's perspective.


METHODS
A conjoint preference experiment began by asking respondents to imagine that they had just been diagnosed with lung cancer. Respondents then chose among procedures that differed regarding treatment modalities, the potential for treatment-related complications, the likelihood of recurrence, provider case volume, and distance needed to travel for treatment. Conjoint analysis derived relative weights for these attributes.


RESULTS
A total of 225 responses were analyzed. Respondents were most willing to accept minimally invasive operations for treatment of their hypothetical lung cancer, followed by stereotactic body radiation therapy (SBRT); they were least willing to accept thoracotomy. Treatment type and risk of recurrence were the most important attributes from the conjoint experiment (each with a relative weight of 0.23), followed by provider volume (relative weight of 0.21), risk of major complications (relative weight of 0.18), and distance needed to travel for treatment (relative weight of 0.15). Procedural and treatment preferences did not vary with demographics, self-reported health status, or familiarity with the procedures.


CONCLUSIONS
Survey respondents preferred minimally invasive operations over SBRT or thoracotomy for treatment of early-stage non-small cell lung cancer. Treatment modality and risk of cancer recurrence were the most important factors associated with treatment preferences. Provider experience outweighed the potential need to travel for lung cancer treatment.
Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: betty.tong@duke.edu.
Betty C
BC
Tong
The Fuqua School of Business, Duke University, Durham, North Carolina.
Scott
S
Wallace
Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Durham, North Carolina.
Matthew G
MG
Hartwig
Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Durham, North Carolina.
Thomas A
TA
D'Amico
The Fuqua School of Business, Duke University, Durham, North Carolina.
Joel C
JC
Huber
D003657:Decision Making; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D010358:Patient Participation; D057240:Patient Preference; D012306:Risk