Screening and Selection: The Case of Mammograms

• 成果类型: Article
• 署名作者: Einav, Liran; Finkelstein, Amy; Oostrom, Tamar; Ostriker, Abigail; Williams, Heidi
• 署名单位: Stanford University; National Bureau of Economic Research; Massachusetts Institute of Technology (MIT); University System of Ohio; Ohio State University
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20191191
• 发表日期: 2020
• 页码: 3836-3870
• 关键词: breast-cancer mortality; FALSE-POSITIVE MAMMOGRAMS; preventive services; NATIONAL BREAST; follow-up; age 40; women; IMPACT; insurance; benefits

摘要

We analyze selection into screening in the context of recommendations that breast cancer screening start at age 40. Combining medical claims with a clinical oncology model, we document that compliers with the recommendation are less likely to have cancer than younger women who select into screening or women who never screen. We show this selection is quantitatively important: shifting the recommendation from age 40 to 45 results in three times as many deaths if compliers were randomly selected than under the estimated patterns of selection. The results highlight the importance of considering characteristics of compliers when making and designing recommendations.