Preferences for Blood-Based Versus Traditional Screening Modalities for Lung and Colorectal Cancers: Insights from a Conjoint Analysis among US Adults

BACKGROUND: Over 80% of eligible adults who smoke are not up-to-date with lung cancer screening, and >40% are overdue for colorectal cancer (CRC) screening. Blood-based screening tests may offer a less burdensome alternative to existing modalities. We used conjoint analysis to assess preferences for blood-based lung cancer and CRC screening compared with traditional methods (low-dose computed tomography [LDCT] for lung cancer; stool tests or colonoscopy for CRC). METHODS: An online choice-based conjoint survey was administered to US adults aged 50-75 years who were not up-to-date with lung cancer and CRC screening. To recruit respondents, we collaborated with a survey research firm (Cint) that partners with multiple survey panels across the US. Participants compared hypothetical screening test combinations varying in modality, frequency, and accuracy. Simulations identified preferred screening strategies, and logistic regression examined factors associated with preferring blood-based screening. RESULTS: Among 1,741 participants, 43.9% preferred blood tests every 3 years for both cancers, while 28.6% favored traditional screening for both. Another 21.9% preferred a blood test for lung cancer and a traditional CRC test, and 5.6% chose LDCT with a CRC blood test. Non-married individuals, those with comorbidities, and those who exercised infrequently were more likely to prefer blood-based screening (p<0.05). Conversely, non-Hispanic Black participants and higher-income individuals were less likely to choose blood tests (p<0.05). CONCLUSIONS: Nearly half of adults not up-to-date with lung cancer and CRC screening preferred blood-based testing for both cancers. IMPACT: Blood-based tests may help reduce barriers and improve lung cancer and CRC screening uptake.