Wang Yi, Ho Peh Joo, Mou Langming, Li Jingmei
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, 117549, Republic of Singapore.
Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), Singapore, 138672, Republic of Singapore.
J Transl Med. 2025 Jan 21;23(1):96. doi: 10.1186/s12967-025-06119-9.
Risk-based breast cancer screening offers a more targeted and potentially cost-effective approach in cancer detection compared to age-based screening. This study aims to understand women's preferences and willingness for undergoing risk assessment tests.
A discrete choice experiment (DCE) was conducted. Six attributes were selected to construct the DCE questionnaire: one-time cost of the test, methods for reducing late-stage breast cancer, annual breast cancer screening expenses, insurance coverage for early-stage breast cancer, family risk correlation, and risk communication methods. Women aged between 21 and 59 were recruited from Singapore. Latent class analysis was performed.
Three hundred twenty-eight women were included in the analysis and classified into two classes: test supporters and non-supporters. Both classes prioritised test costs and screening costs. Among non-cost attributes, the potential to reduce late-stage breast cancer diagnosis was the most influential factor. Insurance coverage increased willingness to undergo testing. Risk communication methods were not significant in influencing the decision of undergoing tests. Non-supporters were less inclined to take the test if family risk correlation was high. Younger women, married women, full-time employees, and those with a history of breast disease were more likely to be supporters. Women with a family history of breast cancer were more likely to be non-supporters.
Financial incentives play a notable role in increasing the uptake of risk-prediction tests. However, the programme's success depends on understanding and addressing the diverse preferences of women. While cost considerations ranked highly, additional strategies are needed to engage groups that are hesitant, particularly those with a high family risk correlation.
与基于年龄的筛查相比，基于风险的乳腺癌筛查在癌症检测方面提供了一种更具针对性且可能更具成本效益的方法。本研究旨在了解女性对接受风险评估测试的偏好和意愿。
进行了一项离散选择实验（DCE）。选择六个属性来构建DCE问卷：测试的一次性成本、降低晚期乳腺癌的方法、年度乳腺癌筛查费用、早期乳腺癌的保险覆盖范围、家族风险相关性以及风险沟通方法。从新加坡招募年龄在21至59岁之间的女性。进行了潜在类别分析。
328名女性被纳入分析并分为两类：测试支持者和非支持者。两类都将测试成本和筛查成本列为优先考虑因素。在非成本属性中，降低晚期乳腺癌诊断的可能性是最具影响力的因素。保险覆盖范围增加了接受测试的意愿。风险沟通方法在影响接受测试的决定方面并不显著。如果家族风险相关性高，非支持者不太倾向于接受测试。年轻女性、已婚女性、全职员工以及有乳腺疾病史的女性更有可能成为支持者。有乳腺癌家族史的女性更有可能成为非支持者。
经济激励在提高风险预测测试的接受度方面发挥着显著作用。然而，该计划的成功取决于理解和满足女性的不同偏好。虽然成本考虑排名很高，但需要额外的策略来吸引犹豫不决的群体，特别是那些家族风险相关性高的群体。
