Public Heterogeneous Preferences for Low-Dose Computed Tomography Lung Cancer Screening Service Delivery in Western China: A Discrete Choice Experiment

Background  Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is an efficient method that can reduce lung cancer mortality in high-risk individuals. However, few studies have attempted to measure the preferences for LDCT LCS service delivery. This study aimed to generate quantitative information on the Chinese population’s preferences for LDCT LCS service delivery. Methods  The general population aged ۴۰ to ۷۴ in the Sichuan province of China was invited to complete an online discrete choice experiment (DCE). The DCE required participants to answer ۱۴ discrete choice questions comprising five attributes: facility levels, facility ownership, travel mode, travel time, and out-of-pocket cost. Choice data were analyzed using mixed logit and latent class logit models.  Results  The study included ۲,۵۲۹ respondents, with ۷۴۶ (۲۹.۵%) identified as being at risk for lung cancer. Mixed logit model analysis revealed that all five attributes significantly influenced respondents’ choices. Facility levels had the highest relative importance (۴۴.۴%), followed by facility ownership (۲۸.۱%), while out-of-pocket cost had the lowest importance (۶.۴%). The atrisk group placed relatively more importance on price and facility ownership compared to the nonrisk group. Latent class logit model identified five distinct classes with varying preferences.  Conclusion  This study revealed significant heterogeneity in preferences for lung cancer screening service attributes among the Chinese population, with facility level and facility ownership being the most important factors. The findings underscore the need for tailored strategies targeting different subgroup preferences to increase screening participation rates and improve early detection outcomes.

کلیدواژه ها:

Discrete Choice Experiment ، Preference Heterogeneity ، Lung Cancer Screening ، Service Delivery