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Assessing Women's Preference and Willingness to Pay for Breast Cancer Screening: A Discrete Choice Experiment Approach Publisher



Tahal R1 ; Nahvijou A2 ; Sari AA1 ; Daroudi R1
Authors
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Authors Affiliations
  1. 1. Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Cancer Research Center of Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Source: Value in Health Regional Issues Published:2025


Abstract

Objectives: This study aimed to explore women's preferences regarding breast cancer screening using a discrete choice experiment and willingness-to-pay analysis. Methods: A discrete-choice experiment was conducted among 255 women aged 40 to 65 years who were referred to health centers in Tehran city. The experiment included attributes such as screening methods (clinical examination and mammography), number of deaths prevented, possibility of misdiagnosis and unnecessary biopsy, screening intervals, and cost of the screening test. A conditional logit model was used to estimate preferences, and willingness-to-pay values were derived from the model coefficients. Results: Women revealed a strong preference for mammography over clinical examination(odds ratio [OR] 1.73; 95% CI 1.47-2.04; P < .001). Compared with 1 death prevented per 1000 women, the ORs for 3 and 6 deaths prevented per 1000 women were 18.1 (95% CI 12.72-25.75; P < .001) and 74.48 (95% CI 49.41-112.27; P < .001), respectively. The ORs for misdiagnosis and unnecessary biopsy rates of 10 of 100 people were 0.006 (95% CI 0.003-0.012; P < .001). Preferences for screening intervals varied, with a higher preference for screening every 4 years (OR 2.77; 95% CI 1.73-4.43; P < .001) compared with annual screening. The cost was also a significant factor, with a decrease in the odds of choosing a screening option as the cost increased (OR 0.139; 95% CI 0.1396-0.1399; P = .001). Conclusions: This study provides valuable insights into women's preferences for breast cancer screening in Iran. © 2025 International Society for Pharmacoeconomics and Outcomes Research, Inc.