The Impact of Breast Cancer Organised Screening Programmes on Uptake, Inequality, and Mortality

Sophie Guthmuller¹ ² (with Vincenzo Carrieri² ³ ⁴ and Ansgar Wübker² ⁵)

1 Health Economics and Policy Division, Vienna University of Economics and Business

2 RWI Essen

3 Magna Graecia University of Catanzaro

4 IZA Bonn

5 Hochschule Harz

We study the impact of Organised Screening Programmes (OSP) for Breast Cancer in Europe on mammography uptake, inequality, and mortality. When an OSP is in place, all women within a certainage group receive, every two years, an invitation for free breast screening. To identify the causal impact of this invitation, we exploit the heterogeneity across European regions in the availability of OSP and in the age eligibility across regions with OSP. Our analysis is based on three data sources: (1) regional information on OSP, (2) individual information on mammography uptake, socioeconomic characteristics, health, and lifestyle related risk factors of women in 21 European countries, and (3) cancer registry data on breast cancer incidence, and mortality. We find new evidence that screening increases by more than 30 percentage points when women are invited. First results from the heterogeneity analysis show that women that respond to the invitation are those at higher risk of developing cancer and those with low preventive healthcare habits. Thus, OSP with a personal invitation manage to reach asymptomatic women at higher risk of developing cancer and with low preventive healthcare habits, i.e. women that are less likely to go for a mammography otherwise. Further analyses will investigate the impact of OSP on socioeconomic inequalities, breast cancer incidence, and mortality.