Analysis of urban residents’ willingness to pay for packaging cancer screening and its influencing factors: a cross-sectional study in Sichuan, China

Packaging cancer screening (PCS) offers a cost-effective approach to detecting multiple cancers simultaneously, optimizing resource use and expanding coverage in resource-limited settings. This study investigates urban Chinese residents' willingness to pay (WTP) for PCS and its determinants to guide policy on cancer screening expansion. Data were collected from urban residents aged 40-74 in China using face-to-face questionnaires. Univariate analysis of willingness to pay for PCS was performed using the chi-square test. A logit regression model was used to conduct the multivariate analysis. Of the 3268 survey respondents included in the analysis, 75.98% were willing to undergo annual screening when the cost of PCS was completely free, and only 22.37% were willing to do so in the case of out-of-pocket payments for the screening. A total of 56.90% of the respondents were willing to pay a portion of the PCS cost. The median WTP was CNY 500, and the mean WTP ranged from CNY 493.15 to 761.96, accounting for 16.44 to 25.40% of the total screening cost. Moreover, WTP was associated with age (50 ~ < 60 years old, OR = 0.762, 95% CI 0.598-0.972; 60 ~ < 70 years old, OR = 0.588, 95% CI 0.454-0.762; and ≥ 70 years old, OR = 0.519, 95% CI 0.364-0.742), education level (junior high school, OR = 1.398, 95% CI 1.168-1.647; high school/technical secondary school/technical school, OR = 1.353, 95% CI 1.064-1.721; university and above, OR = 1.798, 95% CI 1.257-2.571), annual family income (OR = 1.652, 95% CI 1.406-1.942), self-rated health status (fair, OR = 0.759, 95% CI 0.645-0.892; poor, OR = 0.678, 95% CI 0.523-0.879), and region (Shuangliu district, OR = 0.421, 95% CI 0.338-0.525; Zilujing district, OR = 0.196, 95% CI 0.162-0.237). Screening cost significantly influences PCS participation frequency among urban Chinese residents. Free screening increases willingness for annual screening, whereas out-of-pocket payments reduce participation. Over half of residents are willing to contribute partially, covering about 25% of costs. Public awareness campaigns and multi-source financing (government, society, insurance) are recommended to reduce economic barriers and expand screening coverage.