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

Abstract

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. 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. 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. 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.