The Demand for Cancer Screening: Peer Effects or Learning

描述（由申请人提供）：宫颈癌构成了一个重大的疾病负担，特别是在发展中国家。它是全球女性中第二常见的癌症，也是发展中国家女性中最常见的癌症。虽然通过定期筛查可以预防宫颈癌，但许多发展中国家的筛查率仍然很低;即使筛查是免费的。越来越多的研究强调了同伴网络对健康行为的重要性，但同伴影响对癌症筛查的影响程度在很大程度上是未知的。本项目旨在研究同伴影响如何影响宫颈癌筛查的需求，并揭示同伴影响的作用途径。解开同伴网络的影响在经验上是具有挑战性的，因为同伴之间存在相关的不可观察性问题。为了克服这个问题，我们设计了一个独特的随机实验中，我们收集了详细的信息，妇女的同龄人网络在尼日利亚的12个村庄，然后创建随机变化，通过随机分配各种现金奖励（条件是参加筛选），在筛选通过网络。然后，我们利用这种变化，以确定一个女人的筛选决定对她的同龄人的影响。因为我们在网络间的筛选吸收中存在外源性变化，所以我们的结果具有因果解释。了解癌症筛查需求中同伴效应的作用不仅对提高癌症筛查率的策略有影响，而且还可能建议更有效地利用稀缺的预防资源。

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.