Does Retirement Affect Secondary Preventive Care Use? Evidence from Breast Cancer Screening

This paper examines the causal impact of retirement on secondary preventive care use. We focus on breast cancer screening since breast cancer is the most common cancer among women aged 50 and above. We use data from Eurobarometer surveys conducted between 1996 and 2006, covering 25 different European countries. We address the endogeneity of retirement by using age thresholds for pension eligibility in a fuzzy regression discontinuity design. Our study makes additional contributions along several dimensions. First, we examine whether the effect of retirement on breast cancer screening participation differs between countries with and without national organized screening programs. Second, we systematically investigate potential theoretical mechanisms, including some mechanisms that have not been considered previously, such as belief on breast cancer prevention and social insurance coverage. Finally, we apply a novel method, specification curve analysis, to assess the robustness of our results. Our results show that retirement reduces secondary preventive care use. This effect is not driven by changes in health or income. Instead, our evidence suggests that generosity of the social health insurance system and women’s beliefs on cancer prevention and treatment are important mechanisms.