Age In, Age Out: The (Un)intended Consequences of Targeted Screening Programs

Tis paper examines the efectiveness of France’s organized cancer screening programs by leveraging age-based eligibility thresholds to identify causal efects on screening uptake. Using 2019 telephone survey data matched with medico-administrative records from 1,411 women insured by MGEN, we employ a fuzzy regression discontinuity design to estimate Local Average Treatment Efects at program entry and exit ages. Our results reveal dramatic discontinuities in screening behavior: entering mammography screening eligibility at age 50 increases uptake probability by 59 percentage points (pp) (p <0.001), while exiting eligibility at age 75 decreases uptake by 39pp (p= 0.014). For cervical screening, we fnd no signifcant discontinuity at the entry age of 25, but observe a substantial decrease at the exit age of 66 (-30pp,p= 0.080). Importantly, these efects vary signifcantly according to individual risk atitudes measured using the DOSPERT scale. risk-takingwomen drive the positive entry efects for mammography screening (+74pp, p <0.001versus non-signifcant efects forrisk-aversewomen), whilerisk-aversewomen are particularly susceptible to negative exit efects (-31pp,p= 0.035). Tese fndings suggest that age-targeted screening policies create temporary behavioral changes rather than sustained health habits, with heterogeneous impacts based on individual risk preferences. Our results have important implications for designing more personalized public health interventions that account for individual psychological characteristics.