The Trade-Offs that Vietnamese Women Make in Early Detection Services for Breast Cancer: Insights from a Discrete Choice Experiment Using a Latent Class Model

Document Type : Research Articles

Authors

1 Faculty of Pharmacy, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.

2 Social, Economic and Administrative Pharmacy (SEAP) Graduate Program, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.

3 Faculty of Basic Medical Science, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.

4 Department of Office, Ministry of Health, Hanoi 100000, Vietnam.

5 University of Medicine and Pharmacy, Vietnam National University, Hanoi 100000, Vietnam.

Abstract

Introduction: Delays in diagnosis and treatment are common among Vietnamese breast cancer (BC) patients. This study analyzed women’s preferences regarding breast cancer screening (BCS) programs and mammography screening to support the government in implementing population-based BCS. Methods: We conducted literature reviews, focus group discussions, and qualitative interviews to develop the attributes and levels of a discrete choice experiment (DCE) involving [breast cancer screening (BCS) programs and mammography screening. The BCS program included] seven attributes (screening test staff’s gender, method of invitation, free breast self-exam course, waiting time, combined screening test, screening location, and cost), and mammography screening included five attributes (comfort level, screening test staff’s gender, false positives, overdiagnosis, and cost). The choice data were analyzed using a latent class model. Uptake was predicted, and policy scenarios were formulated. Results: A total of 1,023 women, with an average age of 33.4 years, completed the DCE survey. In the BCS scenario, respondents in all classes preferred a combination of screening tests and lower costs, except for the smallest class of participants. Screening location and waiting time were influential components in decision-making for all women. Most participants were sensitive to organizational characteristics and costs. In the mammography screening scenario, respondents’ preferences were strongly influenced by the gender of screening test personnel, false positives, and costs across all classes. Conclusion: Women in Vietnam exhibit heterogeneous preferences for breast cancer screening (BCS) programs and mammography screening. This study provides supporting evidence related to Vietnamese women’s preferences for BCS, which may be valuable for public health authorities.

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