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with relevant follow up for positive tests. Prior to the test, attenders were given a questionnaire about their doubt and arguments in relation to the participation decision, including different willingness-to-pay (WTP) questions. Non-attenders were mailed a similar questionnaire. RESULTS: 70% responded to the questionnaire, which lead to a study sample of 1,053 attenders and 435 non-attenders. Among attenders, 5% had doubt about participation and the most frequent argument was that they did not want to know about the test result. Among non-attenders, 46% would reconsider attendance after further information, the main argument for doubt being the same as for attenders. Further arguments were selfperceived low risk and the trouble and costs associated with attending. Attenders valued the programme significantly higher than non-attenders but this was sensitive to exclusion of bidders who did not pass a simple test for internal consistency of the reported WTP. Doubt about participation was associated with significantly lower WTP among attenders whereas the opposite was the case for non-attenders. Amongst those in doubt, the WTP was the same for attenders and non-attenders. CONCLUSIONS: Up to half of the non-attenders appeared to have doubt about their decision, which presents a potential for increasing the participation rate. Nonattenders in doubt about their participation decision value the programme at a similar level as attenders in doubt, suggesting that non-attenders in doubt do not differ significantly in their base-line valuations from those of the individuals in doubt who choose to attend.

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