OBJECTIVES: A novel multi-cancer early detection (MCED) test can screen for multiple types of cancer via a single blood draw. This screening test could be implemented in a broad segment of the population. As with any screening, there is potential for false positive (FP) results. Economic modeling to assess the value of incorporating MCED testing with conventional cancer screening would need to consider the impact of FPs. The purpose of this study was to pilot-test health state vignettes and procedures that could be used to estimate the disutility (i.e., decrease in health state utility) associated with FPs.

METHODS: In time trade-off interviews, UK general population participants valued health state vignettes drafted based on literature review and clinician input. Ten vignettes described cancer screening with a true negative result or FP results. Each FP vignette described a common diagnostic pathway following an FP result suggesting lung, colorectal, breast, or pancreatic cancer. Every pathway ended with a negative result following diagnostic workup.

RESULTS: A total of 19 participants completed interviews (42.1% male; mean age = 47.0 years). Mean (SD) utilities were 0.974 (0.032) for true negative screening and ranged from 0.833 (0.139) for FP lung cancer screening with a six-month follow-up to 0.958 (0.019) for FP breast cancer screening followed by a diagnostic mammogram and ultrasound. Disutilities for FPs ranged from 0.023 to 0.140.

CONCLUSIONS: All FP results were associated with a disutility compared to a true-negative result. Vignettes describing longer follow-up periods, a greater number of tests, and FPs for types of cancer generally considered to be more severe resulted in greater disutility. Logical results suggest that these procedures could be used in a larger valuation study designed to estimate utility decrements for use in cost-utility analyses examining the value of cancer screening.