HEALTH ECONOMICS Health Econ. 10: 617–634 (2001) ECONOMIC EVALUATION ANALYSING PUBLIC PREFERENCES FOR CANCER SCREENING PROGRAMMES DORTE GYRD-HANSEN a, * AND JES SØGAARD b a Institute of Public Health, Uniersity of Southern Denmark, Odense, Denmark b Danish Institute for Health Serices Research and Deelopment, Copenhagen, Denmark SUMMARY Economic evaluations generally fail to incorporate elements of intangible costs and benefits, such as anxiety and discomfort associated with the screening test and diagnostic test, as well as the magnitude of utility associated with a reduction in the risk of dying from cancer. In the present analysis, 750 respondents were interviewed and asked to rank, according to priority, a number of alternative screening programme set-ups. Focus was on colorectal cancer screening and breast cancer screening. The alternative programmes varied with respect to number of tests performed, risk reduction obtained, probability of a false positive outcome and extent of co-payment. Stated preferences were analysed using discrete ranking modelling and the relative weighting of the programme attributes identified. Applying discrete choice methods to elicit preferences within this area of health care seems justified by the face validity of the results. The signs of the coefficients are in accordance with a priori hypotheses. This paper suggests that large-scale surveys focusing on individuals’ preferences for cancer screening programmes may contribute significantly to the quality of economic evaluations within this field of health care. Copyright © 2001 John Wiley & Sons, Ltd. KEY WORDS — discrete ranking; preferences; screening DOI: 10.1002/hec.622 INTRODUCTION Various methods of screening for cancer diseases have in recent decades been introduced. The cost- liness of these programmes vary depending on costs of screening test, costs of diagnostic test, sensitivity and specificity of the test, as well as the improvement in diagnosis by early detection. Ex- isting and potential screening programmes, such as screening for cervical cancer, breast cancer and colorectal cancer [1–9], have been the focus of economic evaluation in order to determine whether the benefits justify the costs involved. The economic evaluations have however been lim- ited to cost-effectiveness or cost-utility analyses, and have generally failed to incorporate elements of intangible costs and benefits. Moreover, the analyses have been limited by the inability of cost effectiveness analysis to suggest the optimal pro- gramme set-up (screening interval and target group) amongst efficient programmes. More knowledge of the nature of public preferences for screening programmes and their attributes may contribute to the evaluation of such health care programmes. This paper seeks to establish a representative utility function for cancer screening programmes which incorporates the utility and disutility * Correspondence to: Institute of Public Health, University of Southern Denmark, Odense Winsløwparken 19, III, 5000 Odense C, Denmark. Tel.: +45 65 503059; fax: +45 65 918296; e-mail: dgh@sam.sdu.dk Copyright © 2001 John Wiley & Sons, Ltd. Receied 7 December 1999 Accepted 9 March 2001 Published online 25 May 2001