Preferences for treatment outcomes in rectal cancer: A discrete choice experiment among patients and healthy volunteers.

Abstract

AIM: Treatment for rectal cancer can leave patients with a permanent stoma or bowel dysfunction. In this work we aimed to examine preferences for treatment outcomes among people with and without rectal cancer. METHOD: Our discrete choice experiment examined the effect of risk of cancer recurrence, presence of a stoma and bowel dysfunction on treatment preferences in 372 rectal cancer patients without a stoma, 269 with a stoma and 204 people without cancer. RESULTS: Predictors of treatment preferences differed significantly between all groups (p < 0.0001). Avoiding a stoma was more important to stoma-naïve groups, while avoiding bowel dysfunction was more important to those with superior function. Reducing the risk of recurrence was valued highly, and equally, across the groups. CONCLUSION: Experience of a stoma or bowel dysfunction resulted in higher tolerance of those treatment outcomes. Hearing from patients living with different treatment outcomes could help prepare newly diagnosed patients, and facilitate informed decision-making where patients have a choice.