Table 3.

Participant quotes justifying ranking preferences

Common reasons for preferring some health states over others	Selected quotations
Perceived severity of cancer diagnosis	“Colon cancer is really scary, my grandmother died of it.” “I have a terrible fear of [colorectal] cancer.” “My aunt died of lung cancer; I’d automatically think you’d die.” “Anything pancreatic I’d be very concerned about…from people that you hear who’ve had it and died, it just seems really horrible. The kind of cancer is a big factor for me.” “Breast cancer has the best survival rate.” “Colorectal cancer is far less aggressive than pancreatic cancer.” “My personal knowledge of breast cancer [is that] it’s more treatable, not so life threatening. I know a lot of women who have had breast cancer and survived. But pancreatic cancer is quite an aggressive cancer and might be terminal, and I know a friend who died a couple of months from diagnosis.” “I think lung cancer is one that’s really hard to come back from.” “Pancreatic is one of the worst cancers that someone can have.” “I would be really concerned about pancreatic cancer.”
Duration of uncertainty regarding cancer diagnosis	“It’s better to do the tests all at once rather than spread out.” “The actual testing itself isn’t important, it’s the not knowing, the turnaround time.” “If I have cancer, I don’t mind a painful test, but I want to know as quickly as possible.” “The longer the ordeal goes on, the more serious it feels. Psychologically, you would start to feel like a sick person.” “The longer you wait the more upset you will be.” “You worry when your testing can’t happen right away.” “It was based on the time it takes to get results, the duration of time you are in that limbo of indecision.” “I have been through [a false-positive diagnosis]. I had about three weeks waiting, and it was horrible.” “One of the things is the wait for the results, people are really anxious, my mother had to wait eight months before a lung cancer diagnosis.” “Thinking about how long you’re walking around with uncertainty and anxiety – I would be less worried about the type of procedure.” “I clinically suffer from anxiety and worry about uncertainty. I would be desperately worried until I got some result.”
Aspects of follow-up testing	“The colonoscopy seems quite scary, sounds worse than the CT scan. I’ve had a colonoscopy before, and they are awful.” “I hate needles and blood, so injections are avoided for me.” “Invasiveness of the procedures and the numbers of tests was how I made my decision.” “I know how bad the colonoscopy is.” “I have been through [a breast biopsy] and the biopsy hurt a lot.” “[Factors include] the invasiveness of the procedures and if it’s in a personal area.” “I was worried about exposing myself to radiation in the scans.” “Having a biopsy is a major intrusion.” “I preferred the ones that sounded less painful, less invasive, and relatively short.” “I based it on what I felt was invasive and uninvasive.” “The [colonoscopy] prep sounds quite bad and the test itself is quite invasive as well.”

CT computed tomography