The Demand for Cancer Screening: Peer Effects or Learning

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DESCRIPTION (provided by applicant): Cervical cancer constitutes a significant disease burden, especially in developing countries. It is the second most common cancer among women worldwide, and the most common cancer among women in developing countries. Although cervical cancer is preventable through regular screening, screening rates in many developing countries remain low; even when screening is free. A growing body of research highlights the importance of peer networks on the adoption of health behaviors, but the extent to which peer influences affect cancer screening take-up is largely unknown. The aim of this project is to study how peer influences affect the demand for cervical cancer screening, and to shed some light on the channels through which peer effects operate. Untangling the effects of peer networks is empirically challenging because of the problem of correlated unobservables among peers. To overcome this problem, we design a unique randomized experiment in which we collect detailed information about women's peer networks in 12 villages in Nigeria and then create random variation in screening adoption across networks by randomly distributing various cash incentives (conditioned on participating in screening). We then exploit this variation to identify the impact f a woman's screening decision on that of her peers. Because we have exogenous variation in screening take-up across networks, our results have a causal interpretation. Understanding the role of peer effects in the demand for cancer screening not only has implications for strategies to increase cancer screening rates but may also suggest ways in which scarce prevention resources might be targeted more efficiently.