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

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  • Rochelle Belkar
  • Denzil G. Fiebig
  • Marion Haas
  • Rosalie Viney

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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  • Rochelle Belkar & Denzil G. Fiebig & Marion Haas & Rosalie Viney, 2006. "Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 33-47, January.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:1:p:33-47
    DOI: 10.1002/hec.1013
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    Cited by:

    1. Fiebig, Denzil G. & Haas, Marion & Hossain, Ishrat & Street, Deborah J. & Viney, Rosalie, 2009. "Decisions about Pap tests: What influences women and providers?," Social Science & Medicine, Elsevier, vol. 68(10), pages 1766-1774, May.
    2. BOUCKAERT, Nicolas & SCHOKKAERT, Erik, 2013. "Differing types of medical prevention appeal to different individuals," LIDAM Discussion Papers CORE 2013038, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    3. Whynes, David K. & Philips, Zoe & Avis, Mark, 2007. "Why do women participate in the English cervical cancer screening programme?," Journal of Health Economics, Elsevier, vol. 26(2), pages 306-325, March.
    4. Cheah, Yong Kang, 2018. "The utilization of diagnostic tests among the elderly: Evidence from Malaysia," Socio-Economic Planning Sciences, Elsevier, vol. 62(C), pages 121-128.
    5. 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.
    6. Belkar, R. & Fiebig, D.G., 2008. "A Monte Carlo comparison of estimators for a bivariate probit model with selection," Mathematics and Computers in Simulation (MATCOM), Elsevier, vol. 78(2), pages 250-256.
    7. Carman, K.G. & Mosca, I., 2011. "Who Takes Advantage of Free Flu Shots? Examining the Effects of an Expansion in Coverage," Other publications TiSEM 8df9c953-3f99-4856-9403-e, Tilburg University, School of Economics and Management.
    8. Carman, K.G. & Kooreman, P., 2010. "Flu Shots, Mammogram, and the Perception of Probabilities," Other publications TiSEM fba970b8-6fc7-449b-acf9-9, Tilburg University, School of Economics and Management.
    9. Maximilien Nayaradou & Célia Berchi & Olivier Dejardin & Guy Launoy, 2010. "Eliciting Population Preferences for Mass Colorectal Cancer Screening Organization," Medical Decision Making, , vol. 30(2), pages 224-233, March.
    10. Esther W. de Bekker‐Grob & Mandy Ryan & Karen Gerard, 2012. "Discrete choice experiments in health economics: a review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 145-172, February.
    11. Katherine Carman & Ilaria Mosca, 2014. "Who Takes Up Free Flu Shots? Examining the Effects of an Expansion in Coverage," De Economist, Springer, vol. 162(1), pages 1-17, March.
    12. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    13. Denzil G. Fiebig & Rosalie Viney & Stephanie Knox & Marion Haas & Deborah J. Street & Arne R. Hole & Edith Weisberg & Deborah Bateson, 2017. "Consideration Sets and Their Role in Modelling Doctor Recommendations About Contraceptives," Health Economics, John Wiley & Sons, Ltd., vol. 26(1), pages 54-73, January.
    14. Yong Kang Cheah & Chor Foon Tang, 2017. "Factors Influencing the use of Preventive Medical Care in Malaysia: Evidence from National Health and Morbidity Survey Data," Asian Economic Journal, East Asian Economic Association, vol. 31(2), pages 119-137, June.
    15. Katherine Carman & Peter Kooreman, 2014. "Probability perceptions and preventive health care," Journal of Risk and Uncertainty, Springer, vol. 49(1), pages 43-71, August.
    16. Meliyanni Johar & Denzil G. Fiebig & Marion Haas & Rosalie Viney, 2013. "Using repeated choice experiments to evaluate the impact of policy changes on cervical screening," Applied Economics, Taylor & Francis Journals, vol. 45(14), pages 1845-1855, May.

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    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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