OBJECTIVES: To examine Thai adults’ preferences and their willingness-to-pay (WTP) for colorectal cancer (CRC) screening.

METHODS: A discrete choice experiment was conducted among screening-naïve adults aged 50-75 years in the out-patient department of a tertiary care hospital. Six CRC screening attributes, i.e., bowel preparation, pain, risk of complications, risk reduction of CRC-related mortality, screening interval, and out-of-pocket cost, from literature and patient interviews were used to develop a discrete choice experiment questionnaire. Each questionnaire was composed of six choice sets and each choice set contained those six attributes with different levels. Subjects were asked to choose one CRC screening alternative in each choice set. Multinomial logit model was used to determine relative preferences of each attribute and the WTP for all attributes and screening modalities were calculated.

RESULTS: A total of 363 respondents was included in this study. Their average age was 63 years. All attributes, except pain, were statistically significant (p<0.05). The respondents preferred screening with less bowel preparation, no risk of complications, higher risk reduction of CRC-related mortality, longer screening interval, and lower cost. The respondents were willing to pay US$46 and US$44 for less bowel preparation and 10-year screening interval, respectively, and US$3 in exchange for every 1 % increased risk reduction of CRC-related mortality. The respondents were willing to pay for fecal immunochemical test (FIT), colonoscopy, barium enema, CT colonography, and flexible sigmoidoscopy US$244, US$184, US$181, US$149, and US$142, respectively.

CONCLUSIONS: Bowel preparation, risk of complications, risk reduction of CRC-related mortality, screening interval, and cost influence the CRC screening preferences of Thai adults. They preferred FIT to other screening tests. Policy makers can use these findings to improve the success rate of CRC screening campaign.