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Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer

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Author Info
Rochelle Belkar (School of Economics, University of New South Wales, Sydney, Australia)
Denzil G. Fiebig
Marion Haas (CHERE, University of Technology, Sydney, Australia)
Rosalie Viney (CHERE, University of Technology, Sydney, Australia)

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Abstract

The decision to undertake a screening test is conditional upon awareness of screening. From an econometric perspective there is a potential selection problem, if no distinction is made between aware and unaware non-screeners. This paper explores this problem through analysis of the determinants of cervical screening in Australia. Cervical cancer is one of the most preventable and curable forms of cancer. Since 1991 there has been a concerted effort in Australia to recommend and encourage women to have Pap smears every two years. The success of this program can be partly gauged by exploring the determinants of screening for cervical cancer. Using unit record data from the 1995 National Health Survey, an econometric model is developed for whether women have ever screened or not. A proportion of women in the sample contend that they have never heard of a Pap test. The analysis characterizes this group of women and accounts for their presence in the modelling. The paper demonstrates failing to model awareness can result in inconsistent parameter estimates even when the degree of censoring in the sample is relatively small. Copyright © 2005 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1013
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 15 (2006)
Issue (Month): 1 ()
Pages: 33-47
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Handle: RePEc:wly:hlthec:v:15:y:2006:i:1:p:33-47

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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  2. Hsiao, Cheng & Sun, Bao-Hong, 1998. "Modeling survey response bias - with an analysis of the demand for an advanced electronic device," Journal of Econometrics, Elsevier, vol. 89(1-2), pages 15-39, November. [Downloadable!] (restricted)
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  4. Zuehlke, Thomas W & Zeman, Allen R, 1991. "A Comparison of Two-Stage Estimators of Censored Regression Models," The Review of Economics and Statistics, MIT Press, vol. 73(1), pages 185-88, February. [Downloadable!] (restricted)
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  7. Soest, Arthur van & Kapteyn, Arie & Kooreman, Peter, 1993. "Coherency and regularity of demand systems with equality and inequality constraints," Journal of Econometrics, Elsevier, vol. 57(1-3), pages 161-188. [Downloadable!] (restricted)
  8. John Mullahy, 1999. "It'll only hurt a second? Microeconomic determinants of who gets flu shots," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 9-24.
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  10. Kenkel, Donald S, 1994. "The Demand for Preventative Medical Care," Applied Economics, Taylor and Francis Journals, vol. 26(4), pages 313-25, April.
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  11. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-48, July-Aug.. [Downloadable!] (restricted)
  12. Kenkel, D.S., 1988. "Health Behavior, Health Knowledge, And Schooling," Papers 10-88-3, Pennsylvania State - Department of Economics.
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  13. Jones, Andrew M., 2000. "Health econometrics," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 6, pages 265-344 Elsevier. [Downloadable!] (restricted)
  14. Kazumitsu Nawata & Michael McAleer, 2001. "Size Characteristics Of Tests For Sample Selection Bias: A Monte Carlo Comparison And Empirical Example," Econometric Reviews, Taylor and Francis Journals, vol. 20(1), pages 105-112. [Downloadable!] (restricted)
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  1. Denzil Fiebig & Marion Haas & Ishrat Hossain & Rosalie Viney, 2007. "Decisions about Pap tests: What influences women and providers?," Working Papers 2007/11, CHERE, University of Technology, Sydney. [Downloadable!]
  2. Meliyanni Johar & Denzil Fiebig & Marion Haas & Rosalie Viney, 2009. "Evaluating changes in women's attitudes towards cervical screening following a screening promotion campaign and a free vaccination program. CHERE Working Paper 2009/3," Working Papers 2009/3, CHERE, University of Technology, Sydney. [Downloadable!]
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