Public Heterogeneous Preferences for Low-Dose Computed Tomography Lung Cancer Screening Service Delivery in Western China: A Discrete Choice Experiment

Document Type : Original Article


1 Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China

2 Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China

3 School of Business Administration, Faculty of Business Administration, Southwestern University of Finance and Economics, Chengdu, China

4 HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China

5 School of Public Administration, Sichuan University, Chengdu, China

6 Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China

7 Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China

8 Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China

9 State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Chengdu, China


Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is an efficient method that can reduce lung cancer mortality in high-risk individuals. However, few studies have attempted to measure the preferences for LDCT LCS service delivery. This study aimed to generate quantitative information on the Chinese population’s preferences for LDCT LCS service delivery.
The general population aged 40 to 74 in the Sichuan province of China was invited to complete an online discrete choice experiment (DCE). The DCE required participants to answer 14 discrete choice questions comprising five attributes: facility levels, facility ownership, travel mode, travel time, and out-of-pocket cost. Choice data were analyzed using mixed logit and latent class logit models. 
The study included 2,529 respondents, with 746 (29.5%) identified as being at risk for lung cancer. Mixed logit model analysis revealed that all five attributes significantly influenced respondents’ choices. Facility levels had the highest relative importance (44.4%), followed by facility ownership (28.1%), while out-of-pocket cost had the lowest importance (6.4%). The atrisk group placed relatively more importance on price and facility ownership compared to the nonrisk group. Latent class logit model identified five distinct classes with varying preferences.
This study revealed significant heterogeneity in preferences for lung cancer screening service attributes among the Chinese population, with facility level and facility ownership being the most important factors. The findings underscore the need for tailored strategies targeting different subgroup preferences to increase screening participation rates and improve early detection outcomes.


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Articles in Press, Corrected Proof
Available Online from 10 June 2024
  • Receive Date: 28 August 2023
  • Revise Date: 30 March 2024
  • Accept Date: 08 June 2024
  • First Publish Date: 10 June 2024