Do women prefer to have screening tests for Down syndrome that have the lowest screen-positive rate or the highest detection rate?

Objective To assess whether women have a preference for Down syndrome screening test performance. Methods A structured questionnaire exploring women's preferences for screening test performance was administered to women attending their first prenatal visit who wished to have Down syndrome screening performed. Results One hundred and twenty women were interviewed. The majority of women (n = 80) chose a screening test with a low screen-positive rate rather than the highest detection rate. The reasons given for this preference were a desire to minimise the risk of miscarriage of a normal baby and a belief that a detection rate of 80 to 90% was acceptable. However, older women (>37 years) chose a test with the highest detection rate possible, regardless of the higher screen-positive rate, preferring to miscarry a normal baby as a result of a diagnostic test rather than miss the detection of a baby with Down syndrome. Preferences were not influenced by previous screening experience. Conclusions Women express different preferences for screening test performance. Maternal age rather than previous screening experiences appears to be the major influence in these choices. Copyright (C) 2003 John Wiley Sons, Ltd.