Cancer screening invitations in the developing world

Over the last decades, the implementation of effective screening programs has starkly reduced cervical cancer mortality in High-Income Countries (HICs). As a result, roughly 90 percent of cervical cancer deaths nowadays occurs in low- and middle-income countries (LMICs), where nationwide cancer screening programs are nearly absent because of infrastructural barriers. In LMICs that have the capability to implement such programs, participation is often low because of information gaps, cultural, and socio-economic barriers. In this paper, we report results of a field experiment that we conducted within the national screening program of the Republic of Armenia to test whether the screening invitation strategies usually employed in high-income countries (HICs) could enhance screening uptake even in LMICs, despite the aforementioned barriers. We find that the dispatch of invitation letters significantly enhances participation, especially when followed by reminders. Different message frames have no impact. Our empirical results suggest that the implementation of invitation strategies employed in HICs could help to overcome commonly perceived barriers towards screening in LMICs and enhance screening participation.