BACKGROUND: Risk perceptions and attitudes differ across individuals and context. Little is known about how risk preference in monetary domain is correlated with health behavior and treatment preferences.
OBJECTIVES: This study examines how attitudes towards risk-taking in a monetary domain are associated with a preference for a preventative therapy that may reduce the risk of lung cancer in the future.
METHODS: We conducted a discrete-choice experiment (DCE) in which individuals at high risk of lung cancer (aged 50-80 years with at least a 20 pack-year smoking history) chose between pairs of hypothetical treatments (defined by varying levels of reduction in lung cancer risk and risks of adverse events) and a no-treatment option. We measured monetary risk preference as the amount one was willing to invest in a hypothetical investment opportunity with an equal chance of returning 2.5 times the investment or $0 if they were given $100. Two methods were used to assess associations between monetary risk and health preferences. Logit analysis explored whether monetary risk preference is associated with selecting “no treatment” throughout the DCE. Latent-class analysis grouped respondents based on their DCE choices and predicted class membership by their characteristics.
RESULTS: Respondents (n = 803) were willing to invest an average $67.40 (SD, $31.20) in the monetary risk task. The 129 (16%) respondents who always selected “no treatment” chose to invest an average of $61.5 (SD, $36.7). Those who sometimes/always selected a treatment chose to invest $68.6 (SD, $30.0; P = 0.019). Moreover, those who would like to invest more were more likely to have taken various preventative care measures. Latent-class analysis identified 3 classes —a pro-treatment class (50.2%), a treatment-neutral class (29.0%), and a no-treatment class (20.8%)—and found monetary risk neutral/risk-seeking respondents (investment $100) were more likely to be in the pro-treatment class, and extremely risk-averse respondents (investment $0) were more likely to be in the no-treatment class.
CONCLUSIONS: In this study, risk preference in the monetary domain was found to be associated with risk preference in the health domain. People who were less risk averse in the monetary domain were more willing to try innovative medical treatment with uncertain future benefits.
