The effect of organized breast cancer screening on mammography use: Evidence from France

Abstract

In 2004, France introduced a national program of organized breast cancer screening. The national program built on preexisting local programs in some, but not all, départements. Using data from multiple waves of a nationally representative biennial survey of the French population, we estimate the effect of organized screening on the percentage of women obtaining a mammogram. The analysis uses difference-in-differences methods to exploit the fact that the program was targeted at women in a specific age group: 50 to 74 years old. We find that organized screening significantly raised mammography rates among women in the target age range. Just above the lower age threshold, the percentage of women reporting that they had a mammogram in the past 2 years increased by over 10 percentage points after the national program went into effect. Mammography rates increased even more among women in their 60s. Estimated effects are particularly large for women with less education and lower incomes, suggesting that France's organized screening program has reduced socioeconomic disparities in access to mammography.

Does retirement affect secondary preventive care use? Evidence from breast cancer screening

“…Thus, 1 in 8 women in the EU-28 will develop breast cancer before the age of 85 (Ferlay et al, 2007 (Altobelli and Lattanzi, 2014). The screening programs in Finland (1989), the UK (1995) and Sweden (1996) were introduced before the period covered in our empirical analysis (1996-2006, see Such programs have successfully increased mammography use in Europe (Buchmueller and Goldzahl, 2018;Carrieri and Wuebker, 2016;Pletscher, 2017) and decreased mortality in the US and in the UK (Leive and Stratmann, 2015).…”

“…Most countries provide free mammography for women aged over 50 years until 69 or 74 years old every 2 to 3 years, although a few countries offer screening from as early as 40 years. Such programs have successfully increased mammography use in Europe ( Buchmueller and Goldzahl, 2018 , Carrieri and Wuebker, 2016 , Pletscher, 2017 ) and decreased mortality in the US and in the UK ( Leive and Stratmann, 2015 ). 5 Breast cancer screening includes a mammography and a clinical exam performed by a radiologist.…”

Mammograms and Mortality: How Has the Evidence Evolved?

“…With this knowledge in hand, examination of which women select into mammography (as in Kim and Lee 2017;Einav et al 2020), and how these selection patterns translate into heterogeneous treatment effects of mammography (as in Kowalski 2020a) can help policymakers craft better targeted policies. There has already been careful work that examines the impact of policies on mammography (Mehta et al 2015;Bitler and Carpenter 2016;Kadiyala and Strumpf 2016;Lu and Slusky 2016;Buchmueller and Goldzahl 2018;Myerson et al 2020). Such work can be extended to examine the targeting of mammography in light of evidence on mortality from clinical trials.…”

Mammograms and Mortality: How Has the Evidence Evolved?

“…With this knowledge in hand, examination of which women select into mammography (as in Kim and Lee (2017); Einav et al (2019)) and how these selection patterns translate into heterogeneous treatment effects of mammography (as in Kowalski (2020a)) can help policymakers craft better targeted policies. There has already been careful work that examines the impact of policies on mammography (Mehta et al, 2015;Bitler and Carpenter, 2016;Kadiyala and Strumpf, 2016;Lu and Slusky, 2016;Buchmueller and Goldzahl, 2018;Myerson et al, 2020). Such work can be extended to examine the targeting of mammography in light of evidence on mortality from clinical trials.…”