Government Recommendations and Health Behaviors: Evidence from Breast Cancer Screening Guidelines

Brandyn Churchill and Emily Lawler

No 34368, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: We provide novel evidence on how healthcare decision-making responds to changes in government recommendations by studying the United States Preventive Services Task Force’s 2009 decision to stop recommending mammogram screenings for women aged 40-49. Using a difference-in-differences identification strategy, we find that the guideline revision reduced mammography among 40-49-year-old women by 6-10 percent (from a baseline rate of 48.8 percent) relative to their older counterparts. We also identify large spillovers onto women aged 30-39 who were subsequently 25 percent less likely to receive a mammogram recommendation (from a baseline rate of 22.8 percent) and up to 60 percent less likely to receive a mammogram (from a baseline rate of 12.6 percent). Additional analyses suggest the revision reduced overdiagnosis of early-stage tumors. Finally, we find that the 2009 update increased confusion about recommendations for preventing cancer.

JEL-codes: I12 I18 (search for similar items in EconPapers)
Date: 2025-10
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