Disentangling the determinants of interest and willingness-to-pay for breast cancer susceptibility testing in the general population: a cross-sectional Web-based survey among women of Québec (Canada)

Abstract

ObjectivesTo identify common and specific individual factors that favour or impede women’s interest in and willingness-to-pay (WTP) for breast cancer susceptibility testing (BCST) and to identify the most impactful factors on both outcome measures.Design and methodsThis study used a self-administered cross-sectional Web-based questionnaire that included hypothetical scenarios about the availability of a new genetic test for breast cancer.ParticipantsFrench-speaking women of the general population of Québec (Canada), aged between 35 and 69 years, were identified from a Web-based panel (2410 met the selection criteria, 1160 were reached and 1031 completed the survey).MeasuresThe outcomes are the level of interest in and the range of WTP for BCST. Three categories of individual factors identified in the literature were used as potential explanatory factors, that is, demographic, clinical and psychosocial.ResultsDescriptive statistics indicated that the vast majority of sampled women are interested in BCST (90%). Among those, more than half of them are willing-to-pay for such a test (57%). The regression models pointed out several factors associated with both outcomes (eg, age, income, family history, locus of control-powerful others) and marginal effects were used to highlight the most impactful factors for each outcome.ConclusionThe results of this study provide a proxy of the readiness of women of the general population to use and to pay for BCST. They also offer insights for developing inclusive and specific strategies to foster informed decision-making and guide the services offered by health organisations corresponding to women’s preferences and needs.

Factors Associated With the People Preferences for the Breast Cancer Genetic Tests: a Systematic Review

“…There were seven factors regarding health related factors identi ed in the included studies. Family history of breast cancer (21,27,28,30,38) and personal history of breast disease or presence of BC (30,31,41,42) were identi ed as positively strong association with preference on genetic tests. Based on vote counting there is inconclusive result for the relation of family history of other cancer (24,28), the number of previous breast biopsies (21), presence of rstdegree relatives affected with cancer (39), presence of family members testing positive (22,23), and prior hormonal treatment member(s) testing positive (29) with the preference because of any evidence of positive or negative effects of the variables.…”

“…All selected studies except one of them (19) were rated high-quality in reviews. Low (20)(21)(22)(23)(24)(25)(26)(27) or unclear (10,19,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) respondent rates and unclear the adjustment for confounding risk factors (10,19,20,22,23,28,29,31,35,36,39,42) were the reasons why the studies did not achieve 100% of the criteria.…”

“…Twelve studies were conducted in the USA (10, 22-25, 27, 35-37, 39, 40, 42) four in the Asia (India, South Korea, Singapore, and Saudi Arabia) (19,(28)(29)(30), ve in Canada (21,26,31,38,41), and four in Israeli (32), Italy (34), Germany (33), and UK (20).…”

“…Sample sizes varied from 28 (36) to 2410 ( 21) with one study including patients with breast and ovarian cancer (19), six studies including high risk (22,23,28,31,36,39) as well as breast cancer patients relative, a number of nine studies including people in general population (10,21,24,25,30,(32)(33)(34)37), and three studies including Jewish people (20,35,42) as sample size, although a number of six studies including a combination of patients, high risks or people from the general population (26,27,29,38,40,41). Although all considered women as samples, four papers included men as a sample group, too (20,28,31,39).…”

“…A number of eleven factors were identi ed in the selected articles that their association between preferences of genetic tests were addressed. Age were assessed in 19 articles that one (39) study declared a positive relationship and ve (21,24,28,30,31) Between gender as well as religion and preferences did not nd any positive and negative relation while a number of ve (20,28,31,39) and two (26,41) articles displayed any relation between them, respectively.…”