Laryngeal cancer treatment decision making: A conjoint analysis of general public attitudes and priorities

Objective: Patients with advanced laryngeal cancer are typically presented with divergent treatment options, namely chemoradiation versus total laryngectomy. This study aims to understand general perspectives of the factors involved in this decision-making process. Methods: Surveys were constructed using specialized conjoint analysis software. Seven attributes integral to the decision-making process for advanced laryngeal cancer treatment were included. Results: Three hundred one healthy adult volunteers completed the decision-making program. The relative impact of each treatment attribute on decision making across all participants was scored with an average importance score (standard deviation) as follows: Lifespan 22.2% (+/- 8.5), Voicing 21.4% (+/- 5.9), Swallowing 19.1% (+/- 7.3), Cancer Cure 14.9% (+/- 6.2), Mode of Breathing 11.0% (+/- 3.7), Self-Image 6.7% (+/- 2.9), and Treatment Type 4.8% (+/- 3.0). Conclusions: General public opinion ranked lifespan, voicing, and swallowing aspects as similarly important, and all were ranked more important than probability of cure. These data demonstrate a variety of priorities among participants and the need for tailored discussions when determining treatment choice for advanced laryngeal cancer. Level of Evidence: Level 4.