Heterogeneity in how women value risk-stratified breast screening

Purpose: Risk-stratified screening has potential to improve the cost effectiveness of national breast cancer screening programs. This study aimed to inform a socially acceptable and equitable implementation framework by determining what influences a woman's decision to accept a personalized breast cancer risk assessment and what the relative impact of these key determinants is. Methods: Multicriteria decision analysis was used to elicit the relative weights for 8 criteria that women reported influenced their decision. Preference heterogeneity was explored through cluster analysis. Results: The 2 criteria valued most by the 347 participants related to program access, “Mode of invitation” and “Testing process”. Both criteria significantly influenced participation (P